How California Became France

BigT

CAGiversary!
I've been following the budget crisis in California for quite some time and I think it may be a harbinger of what is to come nationally...

The Wall Street Journal article below is a great summary:
http://online.wsj.com/article/SB123517419077037281.html

Some high points:
As California goes, says an old cliché, so goes the nation. Oh my.

These days, the Golden State leads the nation on economic and fiscal dysfunction, from the empty homes spread across the Central Valley to the highest state budget shortfall in the nation's history. Meanwhile, its political class pioneers denial in the face of catastrophe.

Even discounting for the impact of global recession, the most populous state's ills are unique and self-inflicted -- and avoidable. In the last three decades, California expanded the public sector and regulation to Europe-like dimensions. Schools, state employees, health care, even dog kennels, benefited from largesse in flush times. Government workers got 16 official holidays, everyone else six. The state dabbled with universal health care and adopted strict environmental standards. In short, California went where our new president and Nancy Pelosi of San Francisco want America to go.

California is in a French-like bind: unable to afford a welfare-type state, and unable to overhaul it. "The people say they want all these programs, then there's nothing they want to pay for," says Hector De La Torre, a Democratic assemblyman. "The schizophrenia in the legislature reflects the peoples'."
 
Big T, what are your thoughts on the movie "Sicko"?

Many other countries such as Britain, France and Canada have done much more than dabbled in universal health care and their populations don't seem to be suffering on the whole.
 
WSJ's becoming such a rag...

Every state is in a very tight financial bind -- the author picks on California and tries to attribute it to their progressive legislation? Lame.

Why don't we instead talk about the economic crunch conservative states are going through and attribute that to lack of progressive legislation? Oh, right, because that doesn't reaffirm your beliefs...
 
To be fair, California's been in the financial shit for longer than many other states. That doesn't mean it's the fault of progressive policies, but it sure is an easy target.

Get the homos back to marryin'; it'll bring Crate n' Barrel back into solvency, and take CA out of the recession. Which matters more to you, BigT: a balanced budget or your moral imperative?
 
[quote name='fatherofcaitlyn']Big T, what are your thoughts on the movie "Sicko"?

Many other countries such as Britain, France and Canada have done much more than dabbled in universal health care and their populations don't seem to be suffering on the whole.[/quote]

Sicko is pretty inaccurate...

...I got a bit of a chuckle out of the Cuban Potemkin Village that was shown to Moore and his group... if you really think that all Cubans get that type of medical care...

One of the reasons that we're pretty much broke is healthcare: Poor Mexicans who get turned away at Mexican hospitals just cross the border and show up at a random emergency room... untreated HIV with multiple opportunistic infections and low CD4 counts... Uncontrolled diabetics with HgbA1C of 10%, nasty foot ulcers and a creatinine of 10 (bad kidney disease requiring dialysis)... Alcoholics infected with hepatitis C, who come in with decompensated liver failure (Ascites, ecephalopathy)...
-They all get admitted and get million dollar workups: the hospital doesn't get a dime of reimbursement...


Back on topic: Now the sales tax in LA is going to be 9.75% Fun!
 
[quote name='mykevermin']To be fair, California's been in the financial shit for longer than many other states. That doesn't mean it's the fault of progressive policies, but it sure is an easy target.

Get the homos back to marryin'; it'll bring Crate n' Barrel back into solvency, and take CA out of the recession. Which matters more to you, BigT: a balanced budget or your moral imperative?[/quote]

Gay marriage, in the large scheme of things, is a very trivial and unimportant issue. I want spending cuts, dammit!

IMHO, California's biggest issues are:

1.) The state assembly and senate are just a bunch of puppets to the Unions and Special Interest Groups (Teachers, Prison Guards, Government Employees), thus no one is willing to make cuts to spending.

2.) Idiot voters who don't realize that Bond measure = borrowing and who will vote for any proposition that mentions children or fast trains, no matter what the budget impact.

3.) Illegal immigration: the education and healthcare costs of this are extreme.

4.) We are driving out productive members of society and they are being replaced by useless welfare moms and illegals who contribute very little...
 
We need better public health care. Call it what you will, the current system is completely broken, we simply cannot allow our fellow men, women & children to continue suffering at the hand of profit-driven providers. Anyone who doesn't see that is just flat out ignorant -- which is okay, most Americans are understandably ignorant regarding the importance of public health care since most Americans are healthy. They don't have to deal with the reapers at their HMO. It's okay to be ignorant, it's not okay to rally against a necessary cause based on ignorance...
 
It would great if California actually became France. France doesnt have to subsidize a bunch of other countries that complain about social policies despite being the ones who benefit the most from them. Also, moving to California would be easier.

2994934040ca5b05d221.jpg
 
[quote name='mykevermin']To be fair, California's been in the financial shit for longer than many other states. That doesn't mean it's the fault of progressive policies, but it sure is an easy target.

[/QUOTE]

i was going to say that as well, weve been in the shitter for years.

californias problem is simple, it has a spending problem. in 1997 our budget was 100 billion (31 billion from federal funds). in 2007 our budget was 200 billion (60 billion from federal funds)! now, just think about that for a minute. a 100% increase in 10 years?! something is wrong. if our budget had grown naturally over the last 10 years (based on inflation and population increases) wed have a surplus right now.


heres our upcoming budget, just take a look and let your mind be boggled.
55072218.gif


lets see...

30 billion of the budget goes to a broken education system.
nearly 10 billion is going to prisons.
38 billion going to health and human services

there ya go thats 65% of the budget right there. so what do we need, easy. health, education and prison reform. if it wasnt 1130 id look for the articles about how much is spent in california per student in education and how much actually makes it to the classroom level, its disturbing. we can cut the prison budget by releasing prisnoers, changing a few laws and getting rid of 3 strikes. and health... well we need to reboot that.
 
[quote name='Koggit']We need better public health care. Call it what you will, the current system is completely broken, we simply cannot allow our fellow men, women & children to continue suffering at the hand of profit-driven providers. Anyone who doesn't see that is just flat out ignorant -- which is okay, most Americans are understandably ignorant regarding the importance of public health care since most Americans are healthy. They don't have to deal with the reapers at their HMO. It's okay to be ignorant, it's not okay to rally against a necessary cause based on ignorance...[/QUOTE]

I don't know what the hell you're talking about. Everyone is allowed access to health care (even illegal immigrants) and the government already takes care of about 30% of the registered population including the disabled, veterans, elderly, children, and most of the poor. Do you think nationalizing it will make it better? If so then you sir, are the ignorant one. Ok, maybe general health care will be available to a wider range of people and irresponsible people without health care will feel better about themselves but what's really important, specialization, will decrease, and access will decrease- thus longer waiting times for serious problems. Look at Canada, and across Europe, they have been pushing for increased privatization to combat the long waits and continue to push. American's also have the best survival rates for many illnesses including cancers because our health care quality is better. We also perform much much more (really, a lot more) medical research than these other countries with universal health care. The current system isn't completely broken (exaggerating is really lazy). One idea is that we could deregulate and increase market competition to hopefully drive prices down and quality/production up (like retail). Another is we could export dead beat aliens who strain our ER's and instead allow legitimate workers in and a greater percentage of practicing physicians.
 
Such a dead horse, I don't want to get into this again... but you're obviously missing the point entirely (evident by crap like your remark regarding specialists), which is that far too many of our fellow Americans (and their friends & family) are suffering -- in extreme cases, dying -- because HMO execs determine the alternatives to be bad for business. People in need of serious treatment can't get proper care through the current underfunded government programs and cannot even begin to think about getting private coverage because profit-driven companies would simply laugh at their preexisting conditions. It's said so damn often that it loses meaning, but the reason we need universal health care is because those who need health care most are often unable to get it, and that will remain true for as long as profit-driven HMOs are at the helm. Again, yes, it's said so often that it's easy for it to sound no different than statistics regarding world hunger or third-world disease, but it's a very serious problem for many of Americans (the tens of thousands with serious conditions and all of their close friends/family) -- those most in need are being denied, people are dying, lives are being ruined, it's nothing short of a crisis.

Personally, I'm on track for a career I'll most certainly hate simply because it pays well and my sis & mom (sis's caretaker) will need all the financial help I can muster. Hopefully some legislation is passed that either nationalizes health care or shakes the shit out of HMOs (force them to provide care for all). If America gets the change it needs, I'll switch career paths overnight.
 
I'm sure this might be considered overly simplistic but I've always felt that the root of California's issues are because of mass immigration since the 40's, both domestic and otherwise. Swarms flocking to the nice weather and hollywood - any location that size being inundated by a population is going to have these problems.
 
[quote name='thrustbucket']I'm sure this might be considered overly simplistic [/quote]
You are right thrust.
any location that size being inundated by a population is going to have these problems.
That's not true. There are a lot of countries with higher population densities that don't have these problems, because they don't spend like crazy and go into debt like California has.
 
[quote name='rickonker']You are right thrust.

That's not true. There are a lot of countries with higher population densities that don't have these problems, because they don't spend like crazy and go into debt like California has.[/QUOTE]
Also those countries don't get raped by the federal govt. like California does. Billions and billions are siphoned off California's economy every year and given to welfare conservative states.

Billions that should be going to Californians.
 
[quote name='BigT']Sicko is pretty inaccurate.[/QUOTE]

No.

One of the reasons that we're pretty much broke is healthcare

It is a part of it, but not so much for the reasons you listed.

In your post you basically make an argument for universal healthcare as it would be better to foot the bill for the relatively cheap preventive medicine rather than the million dollar catastrophic care.
 
[quote name='BigT']One of the reasons that we're pretty much broke is healthcare: Poor Mexicans who get turned away at Mexican hospitals just cross the border and show up at a random emergency room... untreated HIV with multiple opportunistic infections and low CD4 counts... Uncontrolled diabetics with HgbA1C of 10%, nasty foot ulcers and a creatinine of 10 (bad kidney disease requiring dialysis)... Alcoholics infected with hepatitis C, who come in with decompensated liver failure (Ascites, ecephalopathy)...
-They all get admitted and get million dollar workups: the hospital doesn't get a dime of reimbursement...[/quote]

So...

If we shot all illegals, the US could have universal health care?
 
[quote name='tivo']...our health care quality is better...[/quote]

If you don't look at infant mortality rates and life expectancy, I suppose that could be true.
 
[quote name='rickonker']You are right thrust.

That's not true. There are a lot of countries with higher population densities that don't have these problems, because they don't spend like crazy and go into debt like California has.[/QUOTE]

I wasn't talking about population density, I was talking about population speed of growth.
 
[quote name='Dr Mario Kart']It would great if California actually became France. France doesnt have to subsidize a bunch of other countries that complain about social policies despite being the ones who benefit the most from them. Also, moving to California would be easier.

2994934040ca5b05d221.jpg
[/quote]


Doesn't this chart only show federal tax dollar spent per federal tax dollar paid?
 
[quote name='fatherofcaitlyn']If you don't look at infant mortality rates and life expectancy, I suppose that could be true.[/QUOTE]

It is true. And thinking that life expectancy is a good indication of health care quality is really misguided because other factors not dealing with health care, like murder rates, are included. What you should look at are survival rates of particular illnesses (which i did). They show the quality, effectiveness, and access to particular treatments and that on the whole, American's have it better. This is why so many Canadian's come to the US for specialized care (not included in your life expectancy graphs). Those in favor of national health care think we could provide the same quality, access, and standards to our over 300 million population but this isn't true, but even if it was, it would be a bad idea. Read up on it; factors like the research and development of new drugs would decrease.
 
Less money for penis pills and antidepressants, oh no, how awful..

Yet another flaw of profit-driven health care.. pharma companies are interested in treatments rather than cures, and common ailments instead of serious ones..

Regardless, we're not discussing the nationalization of pharmaceuticals, are we? That's wholly separate (and also in dire need of reform)
 
[quote name='tivo']What you should look at are survival rates of particular illnesses (which i did). They show the quality, effectiveness, and access to particular treatments and that on the whole, American's have it better.[/QUOTE]
http://www.kff.org/insurance/snapshot/chcm010307oth.cfm

Leading when spending 2x as much isn't really anything to brag about..

If China spent 10x as much as America on education, would that mean Communism results in better education?

We have good health care because we dump so much money into it.. we could dump this much into a public system and have even better health care, because we'd be spending it on actual care rather than business expenses (lobbying, reapers' salaries and bonuses for denying care, executives, actuaries to prevent those who need coverage from getting it, etc)
 
[quote name='tivo']What you should look at are survival rates of particular illnesses (which i did). They show the quality, effectiveness, and access to particular treatments and that on the whole, American's have it better.[/QUOTE]
http://www.kff.org/insurance/snapshot/chcm010307oth.cfm

Leading when spending 2x as much isn't really anything to brag about..

If China spent 10x as much as America on education, would that mean Communism results in better education?

We have good health care because we dump so much money into it.. we could dump this much into a public system and have even better health care, because we'd be spending it on actual care rather than business expenses (lobbying, reapers' salaries and bonuses for denying care, actuaries to prevent those who need coverage from getting it, etc)
 
[quote name='Koggit']Less money for penis pills and antidepressants, oh no, how awful..

Yet another flaw of profit-driven health care.. pharma companies are interested in treatments rather than cures, and common ailments instead of serious ones..

Regardless, we're not discussing the nationalization of pharmaceuticals, are we? That's wholly separate (and also in dire need of reform)[/QUOTE]

It slows down innovation and inhibits new technologies from being developed as shown by fewer and fewer medical researching occurring in England. Also with universal health care, medical technologies available are less likely to be used.
 
[quote name='tivo']It slows down innovation and inhibits new technologies from being developed as shown by fewer and fewer medical researching occurring in England. Also with universal health care, medical technologies available are less likely to be used.[/QUOTE]

cum hoc ergo propter hoc

just because something's true about a country with universal health care doesn't mean universal health care is the cause...

christ, i thought this was covered in the chinese education analogue... or high school logic classes...

please state for me, without logical fallacy, why you believe "It slows down innovation and inhibits new technologies from being developed ... Also medical technologies available are less likely to be used" i'd love to hear it
 
Suck on this.

"Leading pharmaceutical companies, including Pfizer, Roche and Merck-Serono, were reducing the amount of clinical research they performed in the United Kingdom. The companies say that the policies of the National Institute for Health and Clinical Excellence (NICE) result in too few UK patients receiving "gold standard" care to provide the comparison group needed for clinical trials."

i.e. national health care doesn't provide enough of the attention and long term study that is required for the development of new products. But the UK doesn't have to worry because the USA is leading the world in development with it's free-market health care system. We do most of the work (see country of residence for nobel prize winners in medicine as some proof of where the major developments are coming from) and these other countries just buy the products.
 
Dude.. flat out.. tell me.. are you that stupid? Just a simple yes or no. I'd like to avoid wasting more of my time if you're not gonna understand anything I give you. You've failed to grasp what I've repeatedly stated -- a fact that should be common sense to anyone capable of rational thought. I'm getting frustrated.

It's extremely poor logic, child-like even, to pretend correlation and causation are linked... to continue to raise such flawed arguments after multiple posts explaining what's wrong with your thought process is just astounding, really.

To be extremely blunt, in English instead of Latin: you cannot attribute differences in health care strictly to whether that nation's care is private or public. You cannot do it. It's extremely flawed reasoning. You're finding effects and then choosing the cause to support your argument. That's a theologian's argument.

America spends the most money in the world on health care. Look at that chart I linked -- the UK spends 2300 per capita with a population of 60mil, America spends 5700 per capita with a population of 305mil. Health care costs money. It's impossible to determine the true cause of pharma companies getting less money*, but do you honestly believe a more likely cause is public vs private than the fact that the UK has less than one-twelfth the amount of money going into health care all together? Nobody's proposing American health care is built to mimic Europe's, I doubt many Americans would want to spend so little on health care, we're discussing nationalizing it, and none of your flawed arguments are pertinent to that discussion. Yeah, all day long you can hunt for statistics to attribute to nationalization of care, but how will you ever know nationalization is the cause? It seems more likely (though again impossible to determine for sure) that the reason American care is superior is because we spend more than other countries -- and we can continue to spend more than other countries on nationalized care.

I know I'm starting to sound like a broken record, but for three posts in a row you made the exact same idiotic mistake of choosing the causation simply because, if true, it would've reaffirmed your belief...


*which again, should not be automatically assumed to be a negative effect -- as I stated, most pharma research is in areas of treatment rather than cures, and common ailments rather than serious ones, because there's more money in giving millions of Americans a daily allergy pill / antidepressant / penis pill / weight loss drug than there is in curing a couple thousand patients of a serious affliction..
 
Alright, I hear you. But my big concern is that this national health care will develop into something like government run public education. Sure I could wait and get a mediocre doctor if I'm hurt but if its serious then I'd rather spend the extra money for a private doctor. Therefore, I'd still be paying for the private care treatment (and the taxes on it) but now on top of that, the government would be taking more money away from me and giving it to someone who's been irresponsible his whole life.
 
You're right, it's a lot like education in that regard: everyone should have access to it, but those who want something better should be allowed to purchase their own.

If you find a good private doctor that you'd rather go to, you can, but that's a luxury -- just like finding and attending a great private school is a luxury. Getting health care, period, is a necessity.. even more-so than getting an education.. which is why it should be available to all Americans. In the current system, a painful amount of people are turned away because they're too sick. That's fucked up. HMOs do their best to only cover healthy people, and they spend hundreds of millions of dollars trying to avoid spending money on the sickest Americans. It's despicable -- it's ruined lives, it's taken lives, and it'll only continue for as long as health coverage remains profit-driven. Your health care provider needs to be thinking of patient interests rather than stock holder interests.

I can sort of understand the opposition to the idea, but again, I have to believe the opposition is rooted in ignorance. Or possibly just selfish douchebaggery. Nationalized health coverage may very well end up causing the quality of your care to decrease (possible, far from certain) or you to end up paying more than you currently do (possible, far from certain) but that's because you, like most Americans, are lucky: you're generally healthy. The need for nationalized coverage is not to help people like you, but it shouldn't be too hard to see the bigger picture and consider the needs of others.
 
[quote name='Koggit']You're right, it's a lot like education in that regard: everyone should have access to it, but those who want something better should be allowed to purchase their own.

If you find a good private doctor that you'd rather go to, you can, but that's a luxury -- just like finding and attending a great private school is a luxury. Getting health care, period, is a necessity.. even more-so than getting an education.. which is why it should be available to all Americans. In the current system, a painful amount of people are turned away because they're too sick. That's fucked up. HMOs do their best to only cover healthy people, and they spend hundreds of millions of dollars trying to avoid spending money on the sickest Americans. It's despicable -- it's ruined lives, it's taken lives, and it'll only continue for as long as health coverage remains profit-driven. Your health care provider needs to be thinking of patient interests rather than stock holder interests.

I can sort of understand the opposition to the idea, but again, I have to believe the opposition is rooted in ignorance. Or possibly just selfish douchebaggery. Nationalized health coverage may very well end up causing the quality of your care to decrease (possible, far from certain) or you to end up paying more than you currently do (possible, far from certain) but that's because you, like most Americans, are lucky: you're generally healthy. The need for nationalized coverage is not to help people like you, but it shouldn't be too hard to see the bigger picture and consider the needs of others.[/QUOTE]
You think the only opposition to nationalized health care is from ignorant or selfish people?
 
[quote name='rickonker']You think the only opposition to nationalized health care is from ignorant or selfish people?[/QUOTE]

Well of course. And the only people that didn't vote for Obama were racist warmongers.
 
I think opposing national health care involves either..

1) Not understanding the need for it -- ignorance. There is a need for it. Americans dying and suffering at the hand of HMO execs is a definite need.

2) Not caring about the need for it -- selfishness. You'd prefer to keep your own situation as good as possible before allowing just the possibility of sacrifice in order to help those who truly need it.

I've discussed the topic extensively with a very wide range of people and have never come across someone opposing nationalized care who didn't fit one of those two generalizations.
 
[quote name='Koggit']I think opposing national health care involves either..

1) Not understanding the need for it -- ignorance. There is a need for it. Americans dying and suffering at the hand of HMO execs is a definite need.

2) Not caring about the need for it -- selfishness. You'd prefer to keep your own situation as good as possible before allowing just the possibility of sacrifice in order to help those who truly need it.

I've discussed the topic extensively with a very wide range of people and have never come across someone who didn't fit one of those two generalizations.[/QUOTE]

So you're saying unless there's nationalized health care, Americans must die and suffer at the hands of HMO execs?
 
That's exactly what I'm saying, and it's the truth.

The absolute only way to get coverage for those who need it most is to remove the capitalism. A capitalistic health care market will always work against the sick.
 
[quote name='Koggit']That's exactly what I'm saying, and it's the truth.

The absolute only way to get coverage for those who need it most is to remove the capitalism. A capitalistic health care market will always work against the sick.[/QUOTE]

Again, just to be clear, you see only two options:

1) Nationalized health care
2) Americans must die and suffer at the hands of HMO execs

Right?
 
I'm not going to keep repeating myself, I've clearly stated my point -- feel free to re-read the thread if you missed it.
 
[quote name='Koggit']I'm not going to keep repeating myself, I've clearly stated my point -- feel free to re-read the thread if you missed it.[/QUOTE]
I'm not asking you to repeat your point. I'm asking you if my interpretation is correct.
 
[quote name='Koggit']You're right, it's a lot like education in that regard: everyone should have access to it, but those who want something better should be allowed to purchase their own.

If you find a good private doctor that you'd rather go to, you can, but that's a luxury -- just like finding and attending a great private school is a luxury. Getting health care, period, is a necessity.. even more-so than getting an education.. which is why it should be available to all Americans. In the current system, a painful amount of people are turned away because they're too sick. That's fucked up. HMOs do their best to only cover healthy people, and they spend hundreds of millions of dollars trying to avoid spending money on the sickest Americans. It's despicable -- it's ruined lives, it's taken lives, and it'll only continue for as long as health coverage remains profit-driven. Your health care provider needs to be thinking of patient interests rather than stock holder interests.

I can sort of understand the opposition to the idea, but again, I have to believe the opposition is rooted in ignorance. Or possibly just selfish douchebaggery. Nationalized health coverage may very well end up causing the quality of your care to decrease (possible, far from certain) or you to end up paying more than you currently do (possible, far from certain) but that's because you, like most Americans, are lucky: you're generally healthy. The need for nationalized coverage is not to help people like you, but it shouldn't be too hard to see the bigger picture and consider the needs of others.[/quote]

It's a complex issue that you are oversimplifying into: National health care good; anything else bad.

You can look at it two ways: from the standpoint of the individual or from that of a population. Certain things that you might want done for yourself may not be cost effective to do on a population level (e.g., screening for a rare genetic disorder). From the standpoint of a population, it may be more cost effective to sacrifice certain members of society who are chronically ill, have little chance of getting better, and tend to use up a large portion of healthcare dollars. Of course, if that person is you or someone whom you love, you would likely beg to differ...

Reimbursement in medical practice is a big issue: we get paid nothing for calling patient's or counseling patients and we get paid next to nothing for clinic visits. If patients have medical, then we get pain literally pennies. It's not like lawyers who can bill by the hour. There is simply very little incentive to promote preventative medicine. Conversely, procedures and surgeries are reimbursed at a high rate... it's pretty ass backwards, but simply moving to a nationalized system won't necessarily fix such problems.

Plus, the elderly, disabled, and poor (the ones who need medical care) already have a form of nationalized insurance: Medicare and Medicaid. Most young/healthy people don't really need health care...
 
I had been looking forward to your response, BigT, and appreciate the unique view you can bring to the table, but..

[quote name='BigT']From the standpoint of a population, it may be more cost effective to sacrifice certain members of society who are chronically ill, have little chance of getting better, and tend to use up a large portion of healthcare dollars.[/QUOTE]

Seriously? Leave the stragglers for the wolves, eh... I expected a more compassionate view from a man whose career is rooted in improving health.

I guess it's safe to peg you as a #2.
 
[quote name='Koggit']I had been looking forward to your response, BigT, and appreciate the unique view you can bring to the table, but..



Seriously? Leave the stragglers for the wolves, eh... I expected a more compassionate view from a man whose career is rooted in improving health.

I guess it's safe to peg you as a #2.[/QUOTE]
At this point, it's safe to peg you as a type of #1.
 
[quote name='BigT']It's a complex issue that you are oversimplifying into: National health care good; anything else bad.[/QUOTE]

I think that optimal is a better word here than good.
 
[quote name='Msut77']I think that optimal is a better word here than good.[/quote]

But that would break the parallelism I was going for in my thinly veiled allusion to Animal Farm. ;)
 
[quote name='Koggit']I had been looking forward to your response, BigT, and appreciate the unique view you can bring to the table, but..



Seriously? Leave the stragglers for the wolves, eh... I expected a more compassionate view from a man whose career is rooted in improving health.

I guess it's safe to peg you as a #2.[/quote]

It wasn't necessarily a reflection of what I believe, but in medicine we struggle with this all the time. If you reach a rather hopeless situation, it is often best for a patient to pursue a hospice DNR/DNI route for various reasons (better quality of life, less chance to be harmed).

The whole population vs. individual thing comes up all the time: we can't test everyone for everything... (not only is it not cost effective, but tests have limited sensitivities and specificities, and in a given population, you are bound to get false positives and false negatives, that may send you on the wrong path). In medicine, we strive for Value.

Value = Quality/Cost

It's a strange arrangement though because the consumers (patients) are insulated from cost and quality is difficult to quatify. For nationalized health care to be beneficial, it would have to raise value by increasing quality and/or reducing cost... can it do that? maybe... but it's definitely not a sure thing (e.g., the gov't runs the DMV and VA healthcare systems so well... so let's have them run the whole healthcare system...)
 
[quote name='BigT']But that would break the parallelism I was going for in my thinly veiled allusion to Animal Farm. ;)[/QUOTE]

Not like anyone has failed to notice your little obsessions by now T.

can it do that?

Yes.

but it's definitely not a sure thing

Right now we spend the most and get among the least, it won't be easy but there is basically zero chance it would be worse.

When you talk about preventative care you say that a universal healthcare system does not necessarily get people to start worrying about it, which is true but it removes barriers and the government could always give incentives to doctors to encourage these visits and care.

You also point out that taxpayers are already footing much of the bill for the older and usually more expensive demographics while young people reap relatively few benefits. The US basically pays so much because of these extra layers of bureaucracy that exists to deny its citizens care and then allows people to be shunted off of the private system and/or on to the public one the second profits are risked.
 
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[quote name='BigT']It wasn't necessarily a reflection of what I believe, but in medicine we struggle with this all the time. If you reach a rather hopeless situation, it is often best for a patient to pursue a hospice DNR/DNI route for various reasons (better quality of life, less chance to be harmed).

The whole population vs. individual thing comes up all the time: we can't test everyone for everything... (not only is it not cost effective, but tests have limited sensitivities and specificities, and in a given population, you are bound to get false positives and false negatives, that may send you on the wrong path). In medicine, we strive for Value.

Value = Quality/Cost

It's a strange arrangement though because the consumers (patients) are insulated from cost and quality is difficult to quatify. For nationalized health care to be beneficial, it would have to raise value by increasing quality and/or reducing cost... can it do that? maybe... but it's definitely not a sure thing (e.g., the gov't runs the DMV and VA healthcare systems so well... so let's have them run the whole healthcare system...)[/QUOTE]


The need for nationalization isn't rooted in some need to improve the value of health care, it's to get care for those who need it most, people with serious conditions who can't get health care with a private company due to preexisting conditions.

Essentially, I want everyone to have health insurance through a government agency. That will solve the dilemma of the uninsured. Will everyone benefit - will it improve health care? Impossible to say, it might or it might not, nobody can actually know... regardless, that's a really insignificant issue in the face of what's important: taking care of those in need.

To 'sacrifice' these people because they have a burden that society deems unpleasant to bear is nothing short of inhumane. Whether they're a minority or not, everyone deserves opportunity.
 
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