abbey road d enfer said:
JohnRoberts said:
I don't expect, all you folks to chip in and pay for me, when I go into decline...
Our system here is based exactly on this paradigm. The young pay for the old.
Centuries ago, the old were taken care of by their youngs, but now, the family ties have shattered and we tried to replace them with a social system. It's hard to make it work when there's unemployment, recession and demographic deficit, but there is no reason why it shouldn't continue to work - may need some adjustment, yes, but if we believe there will still be working people in the next years and centuries, it should work.
The extended family model has mostly been broken by the shift from agrarian society to manufacturing, with the portability of households. In addition the diminishing replacement rate in western nations, like France's 1.88 vs. 2.1 that is considered break even, means we're producing less children to support this Ponzi scheme in our dotage. (not unlike Soc security, Medicare, etc).
I plan to die when I run out of money.
Then the consequences are you are ready to commit suicide if you go bankrupt, and billionaires should never die!
If I go bankrupt, this doesn't mean I don't have any earning power. However if I can't afford the next experimental cancer regimen, I will forgo the brief life extension. (I know this is easier to say than do, trust me).
More likely for many medical procedures I could hop a plane to India for surgery at a fraction of the US cost, if that is what I need.... or buy a six pack, and go out with a smile.
I don't think there's any "natural" connection between money and life/death. There is one between money and health, though.
There is a connection between good genes and good heath, and good judgement (behavior) and good health.
Money can mitigate some bad behavior but not all. I have already buried one younger sister ( a smoker) who worked for an insurance company so had excellent coverage. I have another older brother (also a smoker), with enough coverage to beat back cancer once, but last I heard it had returned. I don't smoke, and don't believe that alone will protect me from that end, but so far it has kept it away from my door... and I have outlived my father (another smoker who died of cancer). I see a trend?
I believe strongly in personal responsibility, for our behavior, and don't feel I should pay for others who act irresponsibly. Maybe put a huge tax on cigarettes and use that to help pay for sick smoker's health care. Or maybe just tell them that it can kill them early.. oop's we already do that.
IMO the answer is not to turn healthcare into another bloated post office-like operation, but release the free market spirit that helped build this country.
I agree that bureaucrats leave a lot to be desired, but when it's understood that their primary concern is their own comfort, and secondary is the service they owe to the public, the performance/cost ratio is definitely much better than that of corporations, where the primary concern is maximising the actionnaires dividends, at the expense of the service to the customer.
An instructive unintended consequence of the legislated insurance payout ratio, is that low end insurance plans for many low wage workers would have to be dropped, leaving these employees with no insurance. The Administration has punted on this giving out variances to some 500-1000 insurance plans, many to friends of the administration, but just more evidence of flawed legislation.
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I don't think you understand the version of free market business I desire. Not the current broken, one payer insurance company model where they hold all the cards, so don't have to compete, but a true free market, where the customers get involved in the decision making and cost management.
If a medical clinic offers poor service, long waits, and high cost, they lose all the customers to one that provides better service. Now we don't have any alternative. Major drug store chains have been blocked from providing low cost clinic services by the medical establishment cartel, that likes their current high prices and freedom from competition.
Healthcare is roughly 1/6 of our GDP. That is a huge amount of money. If the game wasn't rigged and we released competitive forces, we'd be able to buy cost effective healthcare in Walmart super stores, instead of having government bureaucrats deciding how many months we have to wait for a MRI, hoping we'll die before we come around in the queue.
Private insurance companies spend more money on their litigations related to denying coverage than on the actual cost of damages.
There are many distortions in the current system that gives the big insurance companies advantages. The tort reform that was left out of the Health care bill as passed, now has a chance of once again seeing the light of day. Screw the lawyers too... (who do you think wrote that bill?)
The EU extols the virtues of competition in order to benefit the end user. The results we see are that prices of electricity and gas are escalating while these new companies that didn't exist 3 years ago are serving huge dividends to their shareholders.
Huh? I just saw part of a speech made by Sarkozy at Davos last week and he is talking the right talk. There are still many structural problems in youth unemployment in france, but I can't protest too loudly with our 9+%.
Over the last few years I have looked a lot at other countries heath care systems, and France has done better than many with excellent pre natal care contributing to above average healthy births. The French system, last numbers I saw was suffering from huge deficits, and was already consolidating facilities and cutting back services a couple years ago. I doubt the budget situation has improved since then.
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I have nothing against providing a safety net for indigent patients, which we already did with emergency room access, but that is incredibly expensive and inefficient. We need to return rationality and personal accountability to health care. We can do better than we were, and surely better than this train wreck legislation.
Of course opinions vary.
JR
PS I have also studied Germany's system which has an interesting mix of private and public providers, but all of these systems are struggling with the same demographic trends I outlined earlier. Germany has a somewhat stronger economy because of their trade surplus, and relatively cheap Euro (thanks to the other EU members budget problems), but even they are struggling with costs.