Will this be adopted as the Senior's Book on Home Remedies?
YouTube - Jim Carrey - Dr. Kevorkian
YouTube - Jim Carrey - Dr. Kevorkian
Healthcare
- Thread starter Al Wohlstrom
- Start date
I never said it would be outlawed, if the policy is changed in any way the holder will revert to the government plan.
First there has to be a government plan which there is none at this time. There would be new restrictions on Private Plans,...they cannot refuse one because of prexisting conditions and cannot throw you off when you get sick..REPEAT: THERE IS NO GOVERNMENT PLAN!!!
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I think Wohlstrom’s underlying issue is at his age he’s afraid he going to be brought before one of the Death Panels Palin has told us about assembled by a President who wasn’t born in the US, and either put to death on the spot or sent to one of the concentration camps Savage has been mentioning.
IMSA
Get the facts about the stability and security you get from health insurance reform | Health Insurance Reform Reality Check
Frequently Asked Questions about Health Insurance Reform | Health Insurance Reform Reality Check
I think Wohlstrom’s underlying issue is at his age he’s afraid he going to be brought before one of the Death Panels Palin has told us about assembled by a President who wasn’t born in the US, and either put to death on the spot or sent to one of the concentration camps Savage has been mentioning.
IMSA
Pete McCluskey.
Lifetime Supporter
Re: Health-care
I'm surprised and disappointed that a debate like this,of concern to a lot of people, which I find interesting even if not affected by it, has to descend to personal attack!
:lurker::lurker:
I'm surprised and disappointed that a debate like this,of concern to a lot of people, which I find interesting even if not affected by it, has to descend to personal attack!
:lurker::lurker:
Jeff Young
GT40s Supporter
Last post, and then I go, but that's not accurate either. If the policy gets changed so that it doesn't meet the minimum standards, you get the opportunity to obtain insurance (potentially at your employer's cost is my understanding) via the National Exchange, which will offer a variety of private plans that do qualify and (right now at least) a public option. You pick. This is something like auto reinsurance facilities that already exist via state regulation and require insurers to offer coverage to high risk drivers -- something like it, not exactly.
I'm on the fence about this. I will admit to believing that I view health care as something like power and water and police and more like infrastructure than most. At the same time, I do not think the plan as constituted will reduce costs etc. and will in fact result in taxes going up. Maybe worth it, hard to tell.
But I do find a lot of the alleged "debate" over healthcare reform to be misguided, missing the point and for the most part flat out inaccurate.
I'm on the fence about this. I will admit to believing that I view health care as something like power and water and police and more like infrastructure than most. At the same time, I do not think the plan as constituted will reduce costs etc. and will in fact result in taxes going up. Maybe worth it, hard to tell.
But I do find a lot of the alleged "debate" over healthcare reform to be misguided, missing the point and for the most part flat out inaccurate.
Saving for a 40 but have never seen one in person. I am planning a pilgimage to Fran's so I can try one on for size and see if it will really work for us or not.
It boils down to this. If you’re a US citizen, you should have affordable health care available to you. No cherry picking by the insurance companies, no reasonable claim denied, no one declined due to pre-existing conditions. Even if you’re insured, there’s a good chance you're only one medical crisis away from bankruptcy. It happens everyday to regular middle class citizens that pay their taxes and do the right things.
Right now the health care industry in this country is a for profit industry that answers to Wall Street and investors with approximately 30% of every premium dollar going to overhead. That does not sound very efficient to me compared to Medicaid overhead . If I had to choose between a bureaucrat that answers to Washington that stands between me and my doctor, or a insurance bureaucrat that answers to shareholders and Wall Street that stands between me and my doctor, I’ll take my chances with the government.
IMSA
Right now the health care industry in this country is a for profit industry that answers to Wall Street and investors with approximately 30% of every premium dollar going to overhead. That does not sound very efficient to me compared to Medicaid overhead . If I had to choose between a bureaucrat that answers to Washington that stands between me and my doctor, or a insurance bureaucrat that answers to shareholders and Wall Street that stands between me and my doctor, I’ll take my chances with the government.
IMSA
IMSA, You keep saying that there is no goverment plan. No kidding! This entire thread is about the PROPOSED healthcare plan that is going to be voted on. The link to the PROPOSED plan that I put up is the same word for word as the THOMAS (Library of Congress) piece that you posted. Done, finished, out of here!
When I looked at the proposed legislation, I read legalize. At that point, one can see the exaggerations on both sides.
After having experienced health care in (over the past 40 years) the:
- United States
- Italy
- Germany
- UK
- Belgium
Systems which are private work better. If I could choose my location for healthcare, I would choose:
- the United States
- Germany
- Belgium
in that order.
I am not supporting the insurance companies, however the government here in the UK clears which procedures, medicine which can be given by a physican. It is not uncommon to hear on BBC radio that some new drug is not allowed by the NHS because of its cost. But it is available in the US of A.
America has a unique opportunity to develop a really new and efficient system, but it won't be with the way, shape and form that is being proposed by the democratic party.
At day's end, it comes down to who you believe. The Obama camp or the Limbaugh / Hannity or ?? camp.
After having experienced health care in (over the past 40 years) the:
- United States
- Italy
- Germany
- UK
- Belgium
Systems which are private work better. If I could choose my location for healthcare, I would choose:
- the United States
- Germany
- Belgium
in that order.
I am not supporting the insurance companies, however the government here in the UK clears which procedures, medicine which can be given by a physican. It is not uncommon to hear on BBC radio that some new drug is not allowed by the NHS because of its cost. But it is available in the US of A.
America has a unique opportunity to develop a really new and efficient system, but it won't be with the way, shape and form that is being proposed by the democratic party.
At day's end, it comes down to who you believe. The Obama camp or the Limbaugh / Hannity or ?? camp.
My remarks to a friend off the WSJ article written by the head of Whole Foods. Walt's response follows this.
To respond to your last point. Yes the U.S. health care system is headed off a cliff, but so is the Italian, UK etc.
FYI, the Italians pay 8% off the top for their old age pension and health care. Companies pay (32 - 34% vs your 8%). Here in the UK, we pay 8.5% and the company pays 12.5. If you make $50K per annum, you and the company would pay more here in the UK.
I don't think anyone would disagree that the U.S. needs reform. It was said last week that David Cameron, leader of the UK Conservative party, had his new born in an NHS hospital with a life threatening disease, and he became a believer in the NHS. Prior to that the Conservatives wanted to begin privatizing parts of the NHS.
The question becomes: Can you trust the guys in power based on what you have seen them do, and who would you trust more to put it right?
From the WSJ article from the head of Whole Foods and a response from a friend:
Subject: Re: Whole Food's CEO, WSJ piece
<style type="text/css"> #AOLMsgPart_2_59c1a477-0807-4274-858e-e2302ecfbfbf #AOLMsgPart_2_a95e7816-54f9-46ba-9190-85d3f761ebb8 DIV {margin:0px;} </style> A few things that quickly came to mind as I read..
“Now employer health insurance benefits are fully tax deductible, but individual health insurance is not.” Tax deductible perhaps for the employer NOT the employee. Under normal circumstances the premiums paid by the employee, for their group coverage from their employer, are not. It takes sizeable medical bills during the year, on top of your premiums, to reach the dollar level for tax deductibility for an individual.
“We should all have the legal right to pu rchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live.” Again this choice currently would mostly apply only to the employer. Because, under what currently exists in the U.S. the employee’s only choice is the insurance company his employer has choosen to contract with; or the individual market, without the benefit of lower cost of being in a group plan. The employee is not allowed to choose any company other than the one already contracted by their employer, if they want their employer to share the cost. Even if they feel the company their employer contracted with is bad, has cheated them in past or even if they believe that insurer’s denial of service caused the death of a loved one.
And this is where, in this country, choice has dimminished as rapidly as prices have risen. In 1989 my employer, at the time, offered its employees a choice between 4 different healthcare insurance companies. A decade later they offered coverage from two healthcare insurance companies or th eir own network. My most recent employer offered one healthcare insurance company or their own network. This limitation of employee choices has created situations such as the one recently reported where in the state of Iowa, a single healthcare insurer now controls 71% of the state’s healthcare insurance market and in Illinois, with five times Iowa's population, 69% of the market is controlled by only 2 insurance companies. Even if insurance companies are allowed to market to all the states, that will not alter the fact that the only choice the employees will have is the one their employer already made for them. Becoming an educated consumer of health care is moot when your insurance company decides where you can go, by who they will or won't pay, and your employer chooses who that insurance company will be. This is where Obama's idea of a Healthcare Insurance Exchange, open to all, similar to what federal employees have, would greatly increase choice. Go here to check out the number of choices federal employees, including the members of Congress, already have...
http://www.opm.gov/insure/health/planinfo/index.asp
“Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year.” I’ll agree, as long as you add criminal penalities for any physician, clinic/hospital administrator who willfully fails to report malptactice they see, as well as job protection for any nurse or other healthcare worker who reports malpractice they see. Because another large factor behind the high cost of malpractice insurance, that the medical establishment doesn’t like to speak of, are the repeat offenders who are perenially protected by the rest of the members of the physicians club. Rather like the molester priests who were shifted from parrish to parrish rather than being exposed and stopped.
A couple of weeks ago Dom you had voiced a measure of approval for the German health care system. One of the aspects that significantly aids the German system (and Swiss) is that the German "Sickness Funds" are not allowed profit. I'll accept that model in a heartbeat; convert our healthcare insurance companies to non-for-profit corporations, have them pay off their shreholders and then be responsible only to their policy holders and operational costs.
But the problem is most people don't seem to understand the difference between for-profit and not-for-profit corporations when you mention such a thing. That not for profit simply means no investors, hence no funds being funneled away from the core purpose of the business to divends and other shareholders payout. Rather than the core purpose and fiduciary responsibility being the return on investment. But when you speak to people and say not-for-profit, so many somehow construe it to mean that people don't get paid. Yet, not-for-profits pay for excellence and performance just as well as their for-profit counterparts, as exemplified by institutions such as the Mayo Clinic, which is currently being pointed to as an example of both quality and cost control. I think you might find this interview with Denis Cortese the President & CEO of Mayo interesting...
http://www.charlierose.com/view/interview/10496
I wholeheartedly agreed when early in the interview he said that we really don't have a system at all.
In the last three deacdes there has been an explosion of for-profit medicine in this country. Hospitals that were once not-for-profit bought out and converted to for-profit entities. Doctors who once had a private practice now partners in for-profit medical groups, such as my own doctor, where they profit not only from payments for seeing their own patients, but the other doctors visits with their patients as well. This explosion in and conversion to for-profit medicine coincides precisely with the rapid rise in American healthcare costs. I get at least three pieces of junk mail advertising from hospitals every week and see at least three or four TV commercials for hospitals everyday, not to mention more than a dozen prescription drug TV commercials daily.
There is a documentary that opened recently titled 'Money Driven Medicine' that looks like it may be very intersting.
http://www.moneydrivenmedicine.org/
http://www.npr.org/templates/player/mediaPlayer.html?action=1&t=1&islist=false&id=111063048&m=111064571
All I know is our "system" is headed over a cliff and something has to be done. Three out of five personal bakruptcies in the U.S. are due to medical bills. Many of those filing for bankrutcy had insurance or believed they did, until their insurance companies started to deny them coverage, even after years of having paid their premiums, for procedures ordered by their physicians. We are the only industrial democracy in the world where you can work hard all of your life, pay your taxes, support your society and suddenly see everything you have worked for and built, gone in an instant because of an illness. None of our economic competitors in the EU or Asia have to live with that fear.
To respond to your last point. Yes the U.S. health care system is headed off a cliff, but so is the Italian, UK etc.
FYI, the Italians pay 8% off the top for their old age pension and health care. Companies pay (32 - 34% vs your 8%). Here in the UK, we pay 8.5% and the company pays 12.5. If you make $50K per annum, you and the company would pay more here in the UK.
I don't think anyone would disagree that the U.S. needs reform. It was said last week that David Cameron, leader of the UK Conservative party, had his new born in an NHS hospital with a life threatening disease, and he became a believer in the NHS. Prior to that the Conservatives wanted to begin privatizing parts of the NHS.
The question becomes: Can you trust the guys in power based on what you have seen them do, and who would you trust more to put it right?
From the WSJ article from the head of Whole Foods and a response from a friend:
Subject: Re: Whole Food's CEO, WSJ piece
<style type="text/css"> #AOLMsgPart_2_59c1a477-0807-4274-858e-e2302ecfbfbf #AOLMsgPart_2_a95e7816-54f9-46ba-9190-85d3f761ebb8 DIV {margin:0px;} </style> A few things that quickly came to mind as I read..
“Now employer health insurance benefits are fully tax deductible, but individual health insurance is not.” Tax deductible perhaps for the employer NOT the employee. Under normal circumstances the premiums paid by the employee, for their group coverage from their employer, are not. It takes sizeable medical bills during the year, on top of your premiums, to reach the dollar level for tax deductibility for an individual.
“We should all have the legal right to pu rchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live.” Again this choice currently would mostly apply only to the employer. Because, under what currently exists in the U.S. the employee’s only choice is the insurance company his employer has choosen to contract with; or the individual market, without the benefit of lower cost of being in a group plan. The employee is not allowed to choose any company other than the one already contracted by their employer, if they want their employer to share the cost. Even if they feel the company their employer contracted with is bad, has cheated them in past or even if they believe that insurer’s denial of service caused the death of a loved one.
And this is where, in this country, choice has dimminished as rapidly as prices have risen. In 1989 my employer, at the time, offered its employees a choice between 4 different healthcare insurance companies. A decade later they offered coverage from two healthcare insurance companies or th eir own network. My most recent employer offered one healthcare insurance company or their own network. This limitation of employee choices has created situations such as the one recently reported where in the state of Iowa, a single healthcare insurer now controls 71% of the state’s healthcare insurance market and in Illinois, with five times Iowa's population, 69% of the market is controlled by only 2 insurance companies. Even if insurance companies are allowed to market to all the states, that will not alter the fact that the only choice the employees will have is the one their employer already made for them. Becoming an educated consumer of health care is moot when your insurance company decides where you can go, by who they will or won't pay, and your employer chooses who that insurance company will be. This is where Obama's idea of a Healthcare Insurance Exchange, open to all, similar to what federal employees have, would greatly increase choice. Go here to check out the number of choices federal employees, including the members of Congress, already have...
http://www.opm.gov/insure/health/planinfo/index.asp
“Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year.” I’ll agree, as long as you add criminal penalities for any physician, clinic/hospital administrator who willfully fails to report malptactice they see, as well as job protection for any nurse or other healthcare worker who reports malpractice they see. Because another large factor behind the high cost of malpractice insurance, that the medical establishment doesn’t like to speak of, are the repeat offenders who are perenially protected by the rest of the members of the physicians club. Rather like the molester priests who were shifted from parrish to parrish rather than being exposed and stopped.
A couple of weeks ago Dom you had voiced a measure of approval for the German health care system. One of the aspects that significantly aids the German system (and Swiss) is that the German "Sickness Funds" are not allowed profit. I'll accept that model in a heartbeat; convert our healthcare insurance companies to non-for-profit corporations, have them pay off their shreholders and then be responsible only to their policy holders and operational costs.
But the problem is most people don't seem to understand the difference between for-profit and not-for-profit corporations when you mention such a thing. That not for profit simply means no investors, hence no funds being funneled away from the core purpose of the business to divends and other shareholders payout. Rather than the core purpose and fiduciary responsibility being the return on investment. But when you speak to people and say not-for-profit, so many somehow construe it to mean that people don't get paid. Yet, not-for-profits pay for excellence and performance just as well as their for-profit counterparts, as exemplified by institutions such as the Mayo Clinic, which is currently being pointed to as an example of both quality and cost control. I think you might find this interview with Denis Cortese the President & CEO of Mayo interesting...
http://www.charlierose.com/view/interview/10496
I wholeheartedly agreed when early in the interview he said that we really don't have a system at all.
In the last three deacdes there has been an explosion of for-profit medicine in this country. Hospitals that were once not-for-profit bought out and converted to for-profit entities. Doctors who once had a private practice now partners in for-profit medical groups, such as my own doctor, where they profit not only from payments for seeing their own patients, but the other doctors visits with their patients as well. This explosion in and conversion to for-profit medicine coincides precisely with the rapid rise in American healthcare costs. I get at least three pieces of junk mail advertising from hospitals every week and see at least three or four TV commercials for hospitals everyday, not to mention more than a dozen prescription drug TV commercials daily.
There is a documentary that opened recently titled 'Money Driven Medicine' that looks like it may be very intersting.
http://www.moneydrivenmedicine.org/
http://www.npr.org/templates/player/mediaPlayer.html?action=1&t=1&islist=false&id=111063048&m=111064571
All I know is our "system" is headed over a cliff and something has to be done. Three out of five personal bakruptcies in the U.S. are due to medical bills. Many of those filing for bankrutcy had insurance or believed they did, until their insurance companies started to deny them coverage, even after years of having paid their premiums, for procedures ordered by their physicians. We are the only industrial democracy in the world where you can work hard all of your life, pay your taxes, support your society and suddenly see everything you have worked for and built, gone in an instant because of an illness. None of our economic competitors in the EU or Asia have to live with that fear.
Domtoni, +1!
Sorry guys, I am a true believer in free market systems, but the health care industry as it exists for most Americans is a coniving monopoly. The truth is that Insurance companies do not want anyone over 40 or anyone with health issues...especially diabetics, people with mental health issues, weight issues, or any problem they can identify as a risk. I understand the need for profit, but too many companies have expoloited the legal language in their policies to dupe the public into paying for services only to refuse their medical claims when the chips are down. Check the facts.
The only people with decent coverage in the US are people employed in large industries that have the means to pay the cost of coverage. Mom and pop businesses just don't have the options available unless they are willing to shoulder the burden of high deductibles and lifetime limits on care, including exclusions for pre-existing conditions. Unfortunately, the majority of jobs created in this country in the last 20 years were from small companies with less than 50 employees and it's not going to change.
Professional Associations have not done a great job of using their buying clout to create comprehensive plans for their constituancy either with a few exceptions.
Something needs to be done. The single largest growth in expenses in the last 20 years has been for health coverage in the US. How long can American businesses compete in the world market with the albatross of medical costs hanging around their necks? How are new entrepeneurs going to create new companies with the huge start up costs associated with health care in order to lure top talent to their companies? One might suppose that this recession has been in recovery with out job growth is due in part to the uncertainty of how companies will deal with this problem.
Its time for change friends. I don't want the government involved in direct care decisions either, but what alternative do you see on the horizon?
Maybe we should start with legislating insurance companies to insure anyone, regardless of risk. Perhaps the government could guarentee risk pools for those individuals to insure that discrimination does not play a part in coverage and reduce the risks for all insurers. WTF, we just bailed out banks and I can't think of a more unworthy group to give assistance to.
Let's take the burden of health care costs from the small companies of today and in the future, create portability of plans wherever you go,allow acess to the best medical care for everyone, create incentives for healthy lifestyles and preventive care specialist, advance mental illness to the forefront of managed care, and give our current and future populations security that in one of the greatest countries in the world that health care will not be rationed or witheld form anyone.
Just my 2 cents.
Garry
Sorry guys, I am a true believer in free market systems, but the health care industry as it exists for most Americans is a coniving monopoly. The truth is that Insurance companies do not want anyone over 40 or anyone with health issues...especially diabetics, people with mental health issues, weight issues, or any problem they can identify as a risk. I understand the need for profit, but too many companies have expoloited the legal language in their policies to dupe the public into paying for services only to refuse their medical claims when the chips are down. Check the facts.
The only people with decent coverage in the US are people employed in large industries that have the means to pay the cost of coverage. Mom and pop businesses just don't have the options available unless they are willing to shoulder the burden of high deductibles and lifetime limits on care, including exclusions for pre-existing conditions. Unfortunately, the majority of jobs created in this country in the last 20 years were from small companies with less than 50 employees and it's not going to change.
Professional Associations have not done a great job of using their buying clout to create comprehensive plans for their constituancy either with a few exceptions.
Something needs to be done. The single largest growth in expenses in the last 20 years has been for health coverage in the US. How long can American businesses compete in the world market with the albatross of medical costs hanging around their necks? How are new entrepeneurs going to create new companies with the huge start up costs associated with health care in order to lure top talent to their companies? One might suppose that this recession has been in recovery with out job growth is due in part to the uncertainty of how companies will deal with this problem.
Its time for change friends. I don't want the government involved in direct care decisions either, but what alternative do you see on the horizon?
Maybe we should start with legislating insurance companies to insure anyone, regardless of risk. Perhaps the government could guarentee risk pools for those individuals to insure that discrimination does not play a part in coverage and reduce the risks for all insurers. WTF, we just bailed out banks and I can't think of a more unworthy group to give assistance to.
Let's take the burden of health care costs from the small companies of today and in the future, create portability of plans wherever you go,allow acess to the best medical care for everyone, create incentives for healthy lifestyles and preventive care specialist, advance mental illness to the forefront of managed care, and give our current and future populations security that in one of the greatest countries in the world that health care will not be rationed or witheld form anyone.
Just my 2 cents.
Garry
Comments from two friends on the WSJ article published earlier here:
Friend 1:
The US has the problem of not only the poor and unemployed who need insurence, but the millions of illegal people who are taxing the health care system. They often go the most expensive route to get cared for by starting out in the emergency wards. Health care costs are inflated to those who are covered and can pay their bills to cover the costs of the rest of these people. Then there are those that don't get treated and won't go in to doctors because of not having any health care, and as a result, get serious illnesses that they would not otherwise have, and then require expensive treatment.
Every legal citizen should have a health care option. If they have no coverage and cannot afford coverage, there is a government health care program. I believe that those who have health care plans such as Pat and I, should be able to continue with these plans with no government penalty. Everyone should have the right to chose the option that they want and can afford.
If the uninsured are now covered by the government and taxpayer money, it would figure that the hospitals and doctors could then lower their costs and reduce the burden on the those existing health car providers and their participants.
There is so much fraud and whaste with the medicare program run by the government. They
cannot efficiently handle this. I cannot imagine what a mess their health care program would be. It is a vehicle to gain the latino votes by adding all illegals onto the program at the Americans expense. The more people you can make dependent on the Democratic party and government, the more control you have over them in a lot of ways including votes. This would be another step in the plan for our country in moving to socialism.
The health care plan is necessary for humanitarian reasons and it supports a political agenda that has been long in the works. I believe health care, food, financing and all resources will ultimately be controlled by the world governments and doled out to people based on their ability to contribute, in other words, their worth in terms of productivity.
Friend 2:
I have an issue with net groups. If all of the politicians were forced to endure the same pains that we do with health care the solution would be immediate! My $9.00 an hour job just had an increase in premium cost. To insure Kandy, Cal and myself would cost us $800 per pay period or $1600 a month!! It's not the best coverage either!
Friend 1:
The US has the problem of not only the poor and unemployed who need insurence, but the millions of illegal people who are taxing the health care system. They often go the most expensive route to get cared for by starting out in the emergency wards. Health care costs are inflated to those who are covered and can pay their bills to cover the costs of the rest of these people. Then there are those that don't get treated and won't go in to doctors because of not having any health care, and as a result, get serious illnesses that they would not otherwise have, and then require expensive treatment.
Every legal citizen should have a health care option. If they have no coverage and cannot afford coverage, there is a government health care program. I believe that those who have health care plans such as Pat and I, should be able to continue with these plans with no government penalty. Everyone should have the right to chose the option that they want and can afford.
If the uninsured are now covered by the government and taxpayer money, it would figure that the hospitals and doctors could then lower their costs and reduce the burden on the those existing health car providers and their participants.
There is so much fraud and whaste with the medicare program run by the government. They
cannot efficiently handle this. I cannot imagine what a mess their health care program would be. It is a vehicle to gain the latino votes by adding all illegals onto the program at the Americans expense. The more people you can make dependent on the Democratic party and government, the more control you have over them in a lot of ways including votes. This would be another step in the plan for our country in moving to socialism.
The health care plan is necessary for humanitarian reasons and it supports a political agenda that has been long in the works. I believe health care, food, financing and all resources will ultimately be controlled by the world governments and doled out to people based on their ability to contribute, in other words, their worth in terms of productivity.
Friend 2:
I have an issue with net groups. If all of the politicians were forced to endure the same pains that we do with health care the solution would be immediate! My $9.00 an hour job just had an increase in premium cost. To insure Kandy, Cal and myself would cost us $800 per pay period or $1600 a month!! It's not the best coverage either!
Another comment from a friend in California. Perhaps other from California can comment on this one. Not really focused on healthcare but on the budgetary problems facing California and other states and countries:
I don’t know if I forwarded this one to Dom but here is something to consider – McClintock, is in my opinion, one of the better ones but even he has had his “incidents”. State Assy, State Senate and now a first term Congressman....In this speech, he is spot on as to what happened here.
BTW – I am a native Californian, have lived all but 18 months out of 57 years in and around NorCal but most of the time here in the Big Tomato. I have followed California politics, passionately, for 45 years.
California as a warning for America
July 13th, 2009, 4:59 pm
Congressman Tom McClintock offered remarks in
Washington, D.C., on Friday to the Competitive
Enterprise Institute and Pacific Research
Institute that clearly illustrate why California
is facing such a large fiscal mess. His beginning
joke is so funny because it is so true:
"I know that everybody likes to poke fun at
California - but I can tell you right now that
despite all of its problems, California remains
one of the best places in the world to build a
successful small business. All you have to do is
start with a successful large business."
Here is the rest of the speech:
Laugh if you will, but let me remind you that
when these policies finish wrecking California,
there are still 49 other states we can all move to - and yours is
one of them.
I should also warn you of the strange sense of
déjà-vu that I have every day on the House floor
as I watch the same folly and blunders that
wrecked California now being passed with reckless abandon in this
Congress.
We passed a "Cash-for-Clunkers" bill the other
day - we did that years ago in California.
Doubling the entire debt every five years? Been there.
Increasing spending at unsustainable rates? Done that.
Save-the-Planet-Carbon-Dioxide restrictions? Got the T-Shirt.
To understand how these policies can utterly
destroy an economy and bankrupt a government, you
have to remember the Golden State in its Golden Age.
A generation ago, California spent about half
what it does today AFTER adjusting for both inflation and
population growth.
And yet, we had the finest highway system in the
world and the finest public school system in the
country. California offered a FREE university
education to every Californian who wanted
one. We produced water and electricity so
cheaply that many communities didn't bother to
measure the stuff. Our unemployment rate
consistently ran well below the national rate and
its diversified economy was nearly recession-proof.
One thing - and one thing only - has changed in
those years: public policy. The political Left
gradually gained dominance over California's
government and has imposed a disastrous agenda of
radical and retrograde policies that have
destroyed the quality of life
that Californians once took for
granted.
The Census Bureau reports that in the last two
years 2/3 of a million more people have moved out
of California than have moved into it. Many are
leaving for the garden spots of Nevada, Arizona and Texas.
Think about that. California is blessed with the
most equitable climate in the entire Western
Hemisphere; it has the most bountiful resources
anywhere in the continental United States; it is
poised on the Pacific Rim in a position to
dominate world trade for the next century, and
yet people are finding a better place to live and
work and raise their families in the middle of
the Nevada and Arizona and Texas deserts.
I submit to you that no conceivable act of God
could wreak such devastation as to turn
California into a less desirable place to live
than the middle of the Nevada Nuclear Test
Range. Only Acts of Government can do that. And they have.
You can trace the collapse of California's
economy to several critical events: the rise of
environmental Ludditism beginning in 1974; the
abandonment of constitutional checks and balances
that once constrained spending and borrowing; and
the rise of rule by public employee unions.
There are other factors as well: litigation,
taxation, illegal immigration - but for the sake
of time let me concentrate on the big three.
The first was the rise of environmental Ludditism
with the election of a radical new-age leftist
named Jerry Brown as governor of the state - an
election that also produced overwhelming liberal
majorities in both legislative houses.
Like Obama today, Brown lost little time in
pursuing his vision of California - an incoherent
combination of pastoral simplicity, European
socialism and centralized planning. At the
center of this world view was a backward ideology
that he called his "era of limits" - the naive
notion that public works were growth inducing and
polluting and that stopping the expansion of
infrastructure somehow excused government from
meeting the needs of an expanding population.
Conservation replaced abundance as the chief aim
of California's public works, and public policy
was redirected to developing irresistible
incentives for the population to concentrate in
dense urban cores rather than to settle in suburban communities.
Brown infused his vision into every aspect of
public policy, and it is a testament to his
thoroughness and tenacity that its basic tenets
have dominated the direction of California
through both Republican and Democratic admi
nistrations.
He canceled the state's highway construction
program, abandoning many routes in
mid-construction. He canceled long-planned
water projects, conveyance facilities and
dams. He established the California Energy
Commission that blocked approval of any
significant new generating capacity. He enacted
volumes of environmental regulations that created
severe impediments to home and commercial
construction, empowering an incipient no-growth
movement that began on the most extreme fringe of
the environmental cause and quickly spread.
This movement reached its zenith with Arnold
Schwarzenegger and the enactment of AB 32 and
companion legislation in 2006. This measure
gives virtually unchecked authority to the
California Air Resources Board to force Draconian
reductions in carbon dioxide emissions by 2020.
This has dire implications to entire segments of
California's economy: agriculture, baking,
distilling, cargo and passenger transportation,
cement production, manufacturing, construction
and energy production, to name a few.
We, too, were promised an explosion of "green
jobs," but exactly the opposite has happened.
Up until that bill took effect, California's
unemployment numbers tracked very closely with
the national unemployment r
ate. But since then,
California's unemployment rate began a steady
upward divergence from the national jobless
figures. Today, California's unemployment rate
is more than two points above the national rate,
and at its highest point since 1941.
The second problem is structural: the collapse of
the checks and balances and other constitutional
and traditional constraints on government spending and borrowing.
Let me mention a few of them.
The State Supreme Court decision in Serrano v.
Priest severed the use of local revenue for local
schools and invited the state take-over of public
education. AB 8 of 1979 - the legislature's
response to Proposition 13 - essentially did the
same thing to local governments generally.
This means that vast bureaucracies have grown up
over the service delivery level, wasting more and
more resources while hamstringing teachers in
their classrooms, wardens in their prisons and city councils in
their towns.
Next, constitutional constraints on fiscal
excesses began to fall. In 1983, Gov. George
Deukmejian approved legislation to remove the
governor's ability to make mid-year budget
corrections without having to return to the
legislature. The loss of this provision A
0exposed
the state to chronic deficit spending by removing
any ability of the governor to rapidly respond to
changing economic conditions.
In 1989, Deukmejian sponsored Proposition 111
that destroyed the Gann Spending Limit that had
held increases in state spending to inflation and
population growth. If that limit had remained
intact, California would be enjoying a budget surplus today.
The disastrous tax increases by Pete Wilson in
1991 and Arnold Schwarzenegger this year were
made possible by this tragic blunder.
Finally, we've watched the constitutional budget
process that had produced relatively punctual and
relatively balanced budgets for nearly 150 years
collapse in favor of an extra-constitutional abomination called
the big five.
That new process, that began under Pete Wilson
and has culminated under Arnold
Schwarzenegger bypasses the entire legislative
deliberative process in favor of an annual deal
struck between the governor and legislative
leaders behind closed doors and handed to the legislature as a
fait accompli.
This short-circuits the separation of powers that
is designed to discipline fiscal excess and it literally bargains
away the line-item veto authority of the governor. It is
a process that
allows legislative leaders to extract concessions
from the executive that would not be possible if
the separation of powers were maintained.
With the checks against excessive spending broken
down, borrowing became the preferred method of
public finance. The Constitutional requirement
that all taxpayer-supported debt be approved by
voters began to erode in the 1930's, when a
depression-era Supreme Court decision allowed the
state to run a temporary deficit in the event of
an economic down-turn - as long as the shortfall
was addressed in the following fiscal year. This
practice was narrowly construed until the Wilson
administration began using it to justify
spreading out a single year's budget deficit over several years.
During the 1980's, Gov. Deukmejian began
employing a legal fiction called a "lease revenue
bond," to circumvent constitutionally required voter approval.
Although Proposition 13 still protects property
owners from unsustainable increases in their
property taxes, most of the other fiscal
constraints are now gone, and California has
entered a period of unprecedented public debt to
finance an unprecedented expansion of state government.
The third factor that also can be traced back to
the 1970's was the radical transform
ation that
took place in the nature and power of the state's
public employee unions. Until that time, state
law prohibited public employee strikes against
the public and prohibited collective bargaining or closed shops.
During the Jerry Brown era, a series of
collective bargaining acts handed to public
sector unions all the rights and powers of
private sector unions - but without any of the
natural constraints on private sector
unions. The unions soon brought these newly-won
powers to bear to elect hand-picked officials to state and local
office.
Today, political expenditures by public employee
unions exceed all other special interest groups,
while they hold compliant majorities in the state
legislature and most local agencies.
The result has been radically escalating
personnel costs and radically deteriorating performance.
The impact on governmental services has been
devastating. Despite exploding budgets, service
delivery is collapsing. Firing incompetent
teachers has become a virtual impossibility,
adding to the deterioration of educational
quality. Essential services can no longer be
performed because labor costs have made it
impossible to sustain those services.
Today, California is like the
shopkeeper who
leased out too much space, ordered too much
inventory, hired too many people and paid them
too much. Every month the shopkeeper covers his
shortfalls with borrowing and bookkeeping
tricks. Ultimately, he will reach a tipping
point where anything he does makes his situation
worse. Borrowing costs are eating him alive and
he's running out of credit. Raising prices
causes his sales to decline. And there's only so
much discretionary spending he can cut.
That's the state's predicament in a
nutshell. California's borrowing costs now
exceed the budget of the entire University of
California and it is increasingly likely that it
will fail to find lenders when it must borrow
billions to pay its bills at the end of this month.
Ignoring dire warnings, Gov. Schwarzenegger and
legislators from both parties earlier this year
imposed the biggest state tax increase in American history.
And I can assure you that the Laffer curve is
alive and well. In the first two months after
the tax increase took effect, state revenues have plunged 33
percent.
I don’t know if I forwarded this one to Dom but here is something to consider – McClintock, is in my opinion, one of the better ones but even he has had his “incidents”. State Assy, State Senate and now a first term Congressman....In this speech, he is spot on as to what happened here.
BTW – I am a native Californian, have lived all but 18 months out of 57 years in and around NorCal but most of the time here in the Big Tomato. I have followed California politics, passionately, for 45 years.
California as a warning for America
July 13th, 2009, 4:59 pm
Congressman Tom McClintock offered remarks in
Washington, D.C., on Friday to the Competitive
Enterprise Institute and Pacific Research
Institute that clearly illustrate why California
is facing such a large fiscal mess. His beginning
joke is so funny because it is so true:
"I know that everybody likes to poke fun at
California - but I can tell you right now that
despite all of its problems, California remains
one of the best places in the world to build a
successful small business. All you have to do is
start with a successful large business."
Here is the rest of the speech:
Laugh if you will, but let me remind you that
when these policies finish wrecking California,
there are still 49 other states we can all move to - and yours is
one of them.
I should also warn you of the strange sense of
déjà-vu that I have every day on the House floor
as I watch the same folly and blunders that
wrecked California now being passed with reckless abandon in this
Congress.
We passed a "Cash-for-Clunkers" bill the other
day - we did that years ago in California.
Doubling the entire debt every five years? Been there.
Increasing spending at unsustainable rates? Done that.
Save-the-Planet-Carbon-Dioxide restrictions? Got the T-Shirt.
To understand how these policies can utterly
destroy an economy and bankrupt a government, you
have to remember the Golden State in its Golden Age.
A generation ago, California spent about half
what it does today AFTER adjusting for both inflation and
population growth.
And yet, we had the finest highway system in the
world and the finest public school system in the
country. California offered a FREE university
education to every Californian who wanted
one. We produced water and electricity so
cheaply that many communities didn't bother to
measure the stuff. Our unemployment rate
consistently ran well below the national rate and
its diversified economy was nearly recession-proof.
One thing - and one thing only - has changed in
those years: public policy. The political Left
gradually gained dominance over California's
government and has imposed a disastrous agenda of
radical and retrograde policies that have
destroyed the quality of life
that Californians once took for
granted.
The Census Bureau reports that in the last two
years 2/3 of a million more people have moved out
of California than have moved into it. Many are
leaving for the garden spots of Nevada, Arizona and Texas.
Think about that. California is blessed with the
most equitable climate in the entire Western
Hemisphere; it has the most bountiful resources
anywhere in the continental United States; it is
poised on the Pacific Rim in a position to
dominate world trade for the next century, and
yet people are finding a better place to live and
work and raise their families in the middle of
the Nevada and Arizona and Texas deserts.
I submit to you that no conceivable act of God
could wreak such devastation as to turn
California into a less desirable place to live
than the middle of the Nevada Nuclear Test
Range. Only Acts of Government can do that. And they have.
You can trace the collapse of California's
economy to several critical events: the rise of
environmental Ludditism beginning in 1974; the
abandonment of constitutional checks and balances
that once constrained spending and borrowing; and
the rise of rule by public employee unions.
There are other factors as well: litigation,
taxation, illegal immigration - but for the sake
of time let me concentrate on the big three.
The first was the rise of environmental Ludditism
with the election of a radical new-age leftist
named Jerry Brown as governor of the state - an
election that also produced overwhelming liberal
majorities in both legislative houses.
Like Obama today, Brown lost little time in
pursuing his vision of California - an incoherent
combination of pastoral simplicity, European
socialism and centralized planning. At the
center of this world view was a backward ideology
that he called his "era of limits" - the naive
notion that public works were growth inducing and
polluting and that stopping the expansion of
infrastructure somehow excused government from
meeting the needs of an expanding population.
Conservation replaced abundance as the chief aim
of California's public works, and public policy
was redirected to developing irresistible
incentives for the population to concentrate in
dense urban cores rather than to settle in suburban communities.
Brown infused his vision into every aspect of
public policy, and it is a testament to his
thoroughness and tenacity that its basic tenets
have dominated the direction of California
through both Republican and Democratic admi
nistrations.
He canceled the state's highway construction
program, abandoning many routes in
mid-construction. He canceled long-planned
water projects, conveyance facilities and
dams. He established the California Energy
Commission that blocked approval of any
significant new generating capacity. He enacted
volumes of environmental regulations that created
severe impediments to home and commercial
construction, empowering an incipient no-growth
movement that began on the most extreme fringe of
the environmental cause and quickly spread.
This movement reached its zenith with Arnold
Schwarzenegger and the enactment of AB 32 and
companion legislation in 2006. This measure
gives virtually unchecked authority to the
California Air Resources Board to force Draconian
reductions in carbon dioxide emissions by 2020.
This has dire implications to entire segments of
California's economy: agriculture, baking,
distilling, cargo and passenger transportation,
cement production, manufacturing, construction
and energy production, to name a few.
We, too, were promised an explosion of "green
jobs," but exactly the opposite has happened.
Up until that bill took effect, California's
unemployment numbers tracked very closely with
the national unemployment r
ate. But since then,
California's unemployment rate began a steady
upward divergence from the national jobless
figures. Today, California's unemployment rate
is more than two points above the national rate,
and at its highest point since 1941.
The second problem is structural: the collapse of
the checks and balances and other constitutional
and traditional constraints on government spending and borrowing.
Let me mention a few of them.
The State Supreme Court decision in Serrano v.
Priest severed the use of local revenue for local
schools and invited the state take-over of public
education. AB 8 of 1979 - the legislature's
response to Proposition 13 - essentially did the
same thing to local governments generally.
This means that vast bureaucracies have grown up
over the service delivery level, wasting more and
more resources while hamstringing teachers in
their classrooms, wardens in their prisons and city councils in
their towns.
Next, constitutional constraints on fiscal
excesses began to fall. In 1983, Gov. George
Deukmejian approved legislation to remove the
governor's ability to make mid-year budget
corrections without having to return to the
legislature. The loss of this provision A
0exposed
the state to chronic deficit spending by removing
any ability of the governor to rapidly respond to
changing economic conditions.
In 1989, Deukmejian sponsored Proposition 111
that destroyed the Gann Spending Limit that had
held increases in state spending to inflation and
population growth. If that limit had remained
intact, California would be enjoying a budget surplus today.
The disastrous tax increases by Pete Wilson in
1991 and Arnold Schwarzenegger this year were
made possible by this tragic blunder.
Finally, we've watched the constitutional budget
process that had produced relatively punctual and
relatively balanced budgets for nearly 150 years
collapse in favor of an extra-constitutional abomination called
the big five.
That new process, that began under Pete Wilson
and has culminated under Arnold
Schwarzenegger bypasses the entire legislative
deliberative process in favor of an annual deal
struck between the governor and legislative
leaders behind closed doors and handed to the legislature as a
fait accompli.
This short-circuits the separation of powers that
is designed to discipline fiscal excess and it literally bargains
away the line-item veto authority of the governor. It is
a process that
allows legislative leaders to extract concessions
from the executive that would not be possible if
the separation of powers were maintained.
With the checks against excessive spending broken
down, borrowing became the preferred method of
public finance. The Constitutional requirement
that all taxpayer-supported debt be approved by
voters began to erode in the 1930's, when a
depression-era Supreme Court decision allowed the
state to run a temporary deficit in the event of
an economic down-turn - as long as the shortfall
was addressed in the following fiscal year. This
practice was narrowly construed until the Wilson
administration began using it to justify
spreading out a single year's budget deficit over several years.
During the 1980's, Gov. Deukmejian began
employing a legal fiction called a "lease revenue
bond," to circumvent constitutionally required voter approval.
Although Proposition 13 still protects property
owners from unsustainable increases in their
property taxes, most of the other fiscal
constraints are now gone, and California has
entered a period of unprecedented public debt to
finance an unprecedented expansion of state government.
The third factor that also can be traced back to
the 1970's was the radical transform
ation that
took place in the nature and power of the state's
public employee unions. Until that time, state
law prohibited public employee strikes against
the public and prohibited collective bargaining or closed shops.
During the Jerry Brown era, a series of
collective bargaining acts handed to public
sector unions all the rights and powers of
private sector unions - but without any of the
natural constraints on private sector
unions. The unions soon brought these newly-won
powers to bear to elect hand-picked officials to state and local
office.
Today, political expenditures by public employee
unions exceed all other special interest groups,
while they hold compliant majorities in the state
legislature and most local agencies.
The result has been radically escalating
personnel costs and radically deteriorating performance.
The impact on governmental services has been
devastating. Despite exploding budgets, service
delivery is collapsing. Firing incompetent
teachers has become a virtual impossibility,
adding to the deterioration of educational
quality. Essential services can no longer be
performed because labor costs have made it
impossible to sustain those services.
Today, California is like the
shopkeeper who
leased out too much space, ordered too much
inventory, hired too many people and paid them
too much. Every month the shopkeeper covers his
shortfalls with borrowing and bookkeeping
tricks. Ultimately, he will reach a tipping
point where anything he does makes his situation
worse. Borrowing costs are eating him alive and
he's running out of credit. Raising prices
causes his sales to decline. And there's only so
much discretionary spending he can cut.
That's the state's predicament in a
nutshell. California's borrowing costs now
exceed the budget of the entire University of
California and it is increasingly likely that it
will fail to find lenders when it must borrow
billions to pay its bills at the end of this month.
Ignoring dire warnings, Gov. Schwarzenegger and
legislators from both parties earlier this year
imposed the biggest state tax increase in American history.
And I can assure you that the Laffer curve is
alive and well. In the first two months after
the tax increase took effect, state revenues have plunged 33
percent.
Catch the first two videos on Yahoo:
Health Care Reform A Cure That's Worse Than the Disease: Tech Ticker, Yahoo! Finance
Now I will shut up !!!
Health Care Reform A Cure That's Worse Than the Disease: Tech Ticker, Yahoo! Finance
Now I will shut up !!!
Well folks, time to open my mouth again. A response about health care and associated costs in Australia.
Hello,
Since you ask, I can tell you a bit about the Australian health care system. A bit of history: in 1983, the Labor Party [they spell the name of the party with the American spelling for historical reasons] took office for the first time in 10 years and kept a campaign pledge. They started Medicare, which has remained through successive years because of its popularity. It is difficult to compare systems for the following reasons:
A population of 21 million in a geography 85% the size of Europe.
A high literacy / educational rate
An immigrant intake that is equal to the US by %
Illegal immigrants aplenty, but not like the US
Almost all hospitals are public hospitals. A few private hospitals exist in metropolitan areas [and more all the time, usually co-located with major public teaching hospitals].
Rural areas have hospitals and even small towns, where local GPs admit and care for patients.
GPs really function like family physicians [Marcus Welby]. My wife and her female partner are suburban GPs – their office is in a converted suburban house. They do house calls without qualms, treat three generations of some families [they have been there for 23 years] and give the home phone number to families with sick children or dying relatives – it has never been abused in 23 years; [yes, people die in their homes as well as in hospials].
HOSPITALS
If you are a ‘public patient’ in a hospital, you receive all care and medicines, etc without charge
You take whoever is on duty to admit you in the relevant speciality
[if you are in an emergency, you wouldn’t care anyway – you’d want the surgeon/cardiologist/etc on duty because he/she is on the spot to treat you.]
You can elect to be a private patient and choose your own doctor, have a private or semi-private room. You need private insurance for this.
To be admitted to a private hospital, you need private insurance. It would be rare to pay any excess for anything.
The government likes you to be a private patient because you either don’t take a bed in a public hospital or you generate revenue for the public hospital.
Private patents do not wait for anything
Public patients can wait for elective procedures [including some fairly urgent ‘electives’ like hip replacement] for a few months to a max of 24 months.
Medicine is on the subsidised list [like the Medicare list in the US, I think – but I could be wrong]. The government negotiates a price for each drug on the list with the pharmaceutical companies, and pays for all prescription medicine – you pay only a dispensing fee of $35 per item and unemployed / retired pay about $3 per prescription. If you want something not on the list, you pay full retail, like the US. The government likes you to use generic medicine, but cannot require it.
If you need cardiac bypass you get it right away. If you have a cancer diagnosis, you get surgery within a few days and chemoTx / radioTx for free. The catch is you need to live near – or travel to – a major hospital. [Well, there are only 21 million people to pay for all of this, so there are few such facilities outside the metro areas].
DOCTOR FEES
Medicare pays 85% of the ‘schedule fee’ for any medical procedure, consultation, etc. This is similar to the concept of the “usual & customary” fee paid by Blue Cross Blue Shield, except that the doctors get more influence in the process [still not very much]. A doctor can charge anything they want to charge. If they choose to charge only the 85%, the government is required to transfer the funds to them within 10 days. If they charge anything over the 85%, the patient pays up front and claims the 85% rebate and is out of pocket for the gap. Specialists are notorious for a big gap. You cannot insure for the gap for outpatient services, but insurance will pay for the gap up to a specified amount for inpatient care.
My wife’s practice costs people about $15-20 out of pocket for adults, and nothing out-of-pocket for children under 12 or retired people.
And what does this cost?
Medicare is mandatory: fees are progressive 1.25 – 1.75% of taxable income, collected along with your income taxes. If you don’t pay taxes, you get the benefit for free. There are a lot of people on public income [some people suggest that the Labor party likes this because they mostly vote for Labor].
The hospitals, public community health, etc, are covered in your income tax. It is difficult to compare overall tax rates between countries because of system differences, but TOTAL taxes are less than the UK and close to the US, but if you drink, smoke or gamble, then you’re really supporting the government!. There are fewer tax deductions [no business lunches / entertaining], but they only introduced capital gains tax about 1990, at a very low rate [no tax on any gains on anything owned prior to then].
The defence budget is lower than in the US, and there are no “earmarks” for pet projects [well, ok, something similar, but not such a big slice of the pie]; the prison bill is lower. The defence budget did have troops in Iraq and does have them in Afghanistan and ships in the Persian Gulf, as well peace keepers in East Timor and the Solomon Islands.
Health specialists earn a good income, similar to the UK & Europe, not as much as the US [nurses more than in the UK; we have a lot of UK/Irish doctors & nurses who move here for the lifestyle and climate]. Malpractice insurance is a fraction of US rates – not such a litigious society. I am a clinical psychologist and do about 12 hours of private practice per week. I provide evidence-based interventions, not psychobabble like in Hollywood. With a few exceptions, people are limited to 12 visits per year of Medicare reimbursement for my fees, so I have to get them better quickly, [further sessions are up to their GP, not anyone else]. With a few exceptions, I only charge a $5 gap to see me and I still make a good living.
INURANCE
Health insurance is private, with different levels of cover [you get what you pay for, including dental, physio and even massage and acupuncture!]
Some companies are not-for-profit mutual societies.
I am 57 years-of-age and my wife is 54; our daughters are 19 & 20 and live at home while they attend University. We pay $2880 per year for full private health insurance for the family. By law, insurance is ‘community rated’ and all fee increases must be approved by a government panel, similar to public utility rates in the US. The younger you are when you join health insurance, the cheaper. My mother moved here when she was about 70 – her annual private insurance cost was the same as two months of her co-payment on her retirement health policy from the university. It would be very rare for an employer to ever provide health insurance – that is a private matter. Some multinational companies are starting to provide health insurance for executives.
I repeat – it is very hard to compare countries and health systems. We like our system and no government could dismantle it, like Medicare in the US.
Phew – I’ve never written this out before...I hope this answers your question.
Hello,
Since you ask, I can tell you a bit about the Australian health care system. A bit of history: in 1983, the Labor Party [they spell the name of the party with the American spelling for historical reasons] took office for the first time in 10 years and kept a campaign pledge. They started Medicare, which has remained through successive years because of its popularity. It is difficult to compare systems for the following reasons:
A population of 21 million in a geography 85% the size of Europe.
A high literacy / educational rate
An immigrant intake that is equal to the US by %
Illegal immigrants aplenty, but not like the US
Almost all hospitals are public hospitals. A few private hospitals exist in metropolitan areas [and more all the time, usually co-located with major public teaching hospitals].
Rural areas have hospitals and even small towns, where local GPs admit and care for patients.
GPs really function like family physicians [Marcus Welby]. My wife and her female partner are suburban GPs – their office is in a converted suburban house. They do house calls without qualms, treat three generations of some families [they have been there for 23 years] and give the home phone number to families with sick children or dying relatives – it has never been abused in 23 years; [yes, people die in their homes as well as in hospials].
HOSPITALS
If you are a ‘public patient’ in a hospital, you receive all care and medicines, etc without charge
You take whoever is on duty to admit you in the relevant speciality
[if you are in an emergency, you wouldn’t care anyway – you’d want the surgeon/cardiologist/etc on duty because he/she is on the spot to treat you.]
You can elect to be a private patient and choose your own doctor, have a private or semi-private room. You need private insurance for this.
To be admitted to a private hospital, you need private insurance. It would be rare to pay any excess for anything.
The government likes you to be a private patient because you either don’t take a bed in a public hospital or you generate revenue for the public hospital.
Private patents do not wait for anything
Public patients can wait for elective procedures [including some fairly urgent ‘electives’ like hip replacement] for a few months to a max of 24 months.
Medicine is on the subsidised list [like the Medicare list in the US, I think – but I could be wrong]. The government negotiates a price for each drug on the list with the pharmaceutical companies, and pays for all prescription medicine – you pay only a dispensing fee of $35 per item and unemployed / retired pay about $3 per prescription. If you want something not on the list, you pay full retail, like the US. The government likes you to use generic medicine, but cannot require it.
If you need cardiac bypass you get it right away. If you have a cancer diagnosis, you get surgery within a few days and chemoTx / radioTx for free. The catch is you need to live near – or travel to – a major hospital. [Well, there are only 21 million people to pay for all of this, so there are few such facilities outside the metro areas].
DOCTOR FEES
Medicare pays 85% of the ‘schedule fee’ for any medical procedure, consultation, etc. This is similar to the concept of the “usual & customary” fee paid by Blue Cross Blue Shield, except that the doctors get more influence in the process [still not very much]. A doctor can charge anything they want to charge. If they choose to charge only the 85%, the government is required to transfer the funds to them within 10 days. If they charge anything over the 85%, the patient pays up front and claims the 85% rebate and is out of pocket for the gap. Specialists are notorious for a big gap. You cannot insure for the gap for outpatient services, but insurance will pay for the gap up to a specified amount for inpatient care.
My wife’s practice costs people about $15-20 out of pocket for adults, and nothing out-of-pocket for children under 12 or retired people.
And what does this cost?
Medicare is mandatory: fees are progressive 1.25 – 1.75% of taxable income, collected along with your income taxes. If you don’t pay taxes, you get the benefit for free. There are a lot of people on public income [some people suggest that the Labor party likes this because they mostly vote for Labor].
The hospitals, public community health, etc, are covered in your income tax. It is difficult to compare overall tax rates between countries because of system differences, but TOTAL taxes are less than the UK and close to the US, but if you drink, smoke or gamble, then you’re really supporting the government!. There are fewer tax deductions [no business lunches / entertaining], but they only introduced capital gains tax about 1990, at a very low rate [no tax on any gains on anything owned prior to then].
The defence budget is lower than in the US, and there are no “earmarks” for pet projects [well, ok, something similar, but not such a big slice of the pie]; the prison bill is lower. The defence budget did have troops in Iraq and does have them in Afghanistan and ships in the Persian Gulf, as well peace keepers in East Timor and the Solomon Islands.
Health specialists earn a good income, similar to the UK & Europe, not as much as the US [nurses more than in the UK; we have a lot of UK/Irish doctors & nurses who move here for the lifestyle and climate]. Malpractice insurance is a fraction of US rates – not such a litigious society. I am a clinical psychologist and do about 12 hours of private practice per week. I provide evidence-based interventions, not psychobabble like in Hollywood. With a few exceptions, people are limited to 12 visits per year of Medicare reimbursement for my fees, so I have to get them better quickly, [further sessions are up to their GP, not anyone else]. With a few exceptions, I only charge a $5 gap to see me and I still make a good living.
INURANCE
Health insurance is private, with different levels of cover [you get what you pay for, including dental, physio and even massage and acupuncture!]
Some companies are not-for-profit mutual societies.
I am 57 years-of-age and my wife is 54; our daughters are 19 & 20 and live at home while they attend University. We pay $2880 per year for full private health insurance for the family. By law, insurance is ‘community rated’ and all fee increases must be approved by a government panel, similar to public utility rates in the US. The younger you are when you join health insurance, the cheaper. My mother moved here when she was about 70 – her annual private insurance cost was the same as two months of her co-payment on her retirement health policy from the university. It would be very rare for an employer to ever provide health insurance – that is a private matter. Some multinational companies are starting to provide health insurance for executives.
I repeat – it is very hard to compare countries and health systems. We like our system and no government could dismantle it, like Medicare in the US.
Phew – I’ve never written this out before...I hope this answers your question.
Domtoni,
It sounds like a very workable plan and a benefit to all. I could live with that. The problem in the US is that private insurance companies have been bitten by the greed bug since around 1990. The change in the insurance industry has been dramatic as our business schools have produced a generation of profit whores that have no qualms or ethics. Unfortunately, our politicians have suffered from the same lack of ethics as the "rulers" in the boardrooms. It's all about the money.
Good doctors and other healthcare workers go to work and for the most part, still have the patients' interest at heart. The sad part is that too many non-medical workers are involved in the treatment process. Mix that in with a very litigious society, and you have the quagmire that is the current US system. It needs fixing, but not the rush job that is being promoted under the current administration. The sad thing is, everyone agrees that it is broken, but there is not a single voice of reason or sanity that is being heard in all of this.
Its really too sad because I fear a generational gap and uprising is inevitable unless we get our act together.
Garry
It sounds like a very workable plan and a benefit to all. I could live with that. The problem in the US is that private insurance companies have been bitten by the greed bug since around 1990. The change in the insurance industry has been dramatic as our business schools have produced a generation of profit whores that have no qualms or ethics. Unfortunately, our politicians have suffered from the same lack of ethics as the "rulers" in the boardrooms. It's all about the money.
Good doctors and other healthcare workers go to work and for the most part, still have the patients' interest at heart. The sad part is that too many non-medical workers are involved in the treatment process. Mix that in with a very litigious society, and you have the quagmire that is the current US system. It needs fixing, but not the rush job that is being promoted under the current administration. The sad thing is, everyone agrees that it is broken, but there is not a single voice of reason or sanity that is being heard in all of this.
Its really too sad because I fear a generational gap and uprising is inevitable unless we get our act together.
Garry
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