America's Debts.

[Darth Wong]

granted, what you say may be true. My issue is this: why should the gold standard example of a replacement for our broken health care system be one that is only slightly less broken?

It covers everyone, and it costs less to boot. If someone offered a privately run improvement to the health care system that could deliver this, you would go apeshit over it. You're just pissing and moaning because your precious "private industry can do no wrong" dogma balloon has been punctured.

[Darth Wong]

Wow, Premiers declaring the sky is falling. Now point to the millions of Canadians uninsured.

I'll point to the fact that Canadians with money run to the US when they need something done because the wait for service in Canada is so long. Canadias come here for their operations, and we go there for cheap drugs.

Actually, the Shouldice clinic in Toronto routinely gets American customers. I talked to quite a few American clients while I was there. People with money go wherever they can get the best treatment; that has no bearing on the fact that a health-care system should do more than help rich people get what they would be able to get anyway.

[The Dude]

There's a reason it's called "elective surgery". Getting breast implants isn't exactly a healthcare priority.

Most elective surgeries are not as frivolous as titjobs or other cosmetic surgeries (which, with the exception of reconstructions, are not covered by medicare anyhow); serious procedures like hip replacements and coronary bypasses are also "elective".

Case in point: my father-in-law, who has been waiting for surgery for "elective" prostate cancer for about 5 months now (in Ontario), has seriously investigated paying out of pocket to get it done in Florida. Just this week, he had to have a second bone scan because of the possibility that the cancer had spread during his wait. He's not loaded, but he's understandably willing to dip heavily into his savings to resolve this.

[Admiral Valdemar]

Most elective surgeries are not as frivolous as titjobs or other cosmetic surgeries (which, with the exception of reconstructions, are not covered by medicare anyhow); serious procedures like hip replacements and coronary bypasses are also "elective".

Case in point: my father-in-law, who has been waiting for surgery for "elective" prostate cancer for about 5 months now (in Ontario), has seriously investigated paying out of pocket to get it done in Florida. Just this week, he had to have a second bone scan because of the possibility that the cancer had spread during his wait. He's not loaded, but he's understandably willing to dip heavily into his savings to resolve this.

I assume it's benign and not in danger of going malignant yet, as it would be seriously hard to swallow the fact that it's life threatening and still only seen as non-essential surgery.

[The Dude]

I assume it's benign and not in danger of going malignant yet, as it would be seriously hard to swallow the fact that it's life threatening and still only seen as non-essential surgery.

I'm not sure how much you know about prostate cancer, but he was rated an 8 on the Gleason scale (i.e. above-average aggressiveness). As I said, there was a real possibility that the cancer had spread since his original diagnosis, hence the recent 2nd scan.

[RedImperator]

An interesting thing to consider is that the President has an MBA from Harvard--and check out the time when he got it. I don't think his decision-making is necessarily the result of any lack of intelligence but instead something which has infected the business world here ever since McNamara and the whiz kids took over at Ford.

Is there any fucked up thing in the last 40 years of the 20th century for which McNamara ISN'T responsible?

[aerius]

Most elective surgeries are not as frivolous as titjobs or other cosmetic surgeries (which, with the exception of reconstructions, are not covered by medicare anyhow); serious procedures like hip replacements and coronary bypasses are also "elective".

True, I was exaggerating a bit, well, a fair bit. But in general elective surgery as I understand it is for conditions which aren't life-threatening.

[Admiral Valdemar]

I'm not sure how much you know about prostate cancer, but he was rated an 8 on the Gleason scale (i.e. above-average aggressiveness). As I said, there was a real possibility that the cancer had spread since his original diagnosis, hence the recent 2nd scan.

Oncology isn't my forté, but I do know that 8-10 is the worst type to really have, usually due to late/incorrect diagnosis. I wish your father-in-law well and hope he makes a full recovery.

[The Dude]

True, I was exaggerating a bit, well, a fair bit. But in general elective surgery as I understand it is for conditions which aren't life-threatening.

Not immediately life-threatening, but waiting weeks or months for surgery for things like breast cancer or partial coronary blockages is obviously going to cost some people very dearly.

[The Dark]

two notes here. That 84K figure conflicts with most numbers i have seen. (IIRC the average American in debt held something in the $7-$10K range, although most Americans had a positive net worth) The only way i can possibly see how it fits is if you include mortgage debt and exclude assets.

The average household personal debt in 1992 was $71,500, according to Wolff, Rutten, and Bayers in Where We Stand, which compared the United States to all other First World nations of the time.

Other comparisons:

Average Household savings were $4,201.

Government debt per person was $12,433. Only Japan and Belgium were higher at the time.

Investment was a mere 17.1% of GDP. Half of the other nations were between 18 and 21%, and the other half 21 to 31%.

The average CEO made 17.5 times the average worker's salary. The next highest multiplier was the UK's 12.4. The lowest was Germany's 6.5.

Only 16.4% of American workers were unionized. Other nations ranged from 25% (Netherlands) to 85.3% (Sweden).

The middle class made up 53.7% of the United States, while other nations were between 58.5% (UK) and 90% (Japan).

The US's poverty rate was 17.1%. Next highest was Canada's 12.6%, going down to Norway's 5.2%.

The US's health care expenditures were 13.4% of GDP. Canada's were 10%. Denmark's were only 6.5%, or less than half that of the US.

Only 40% of the American public was covered under the public expenditures. The Netherlands was at 77%. Germany was 92%.

Switzerland, Spain, and Belgium had 98%. France and Austria were at 99%, and all other nations were 100% covered.

Among industrial nations, the US has the highest infant mortality rate (10.4 per million) and 1-to-4 year old mortality rate (101.5 per 200,000).

Likewise, the death rate of 15 to 24 year olds is highest in the US. Even subtracting murders (for whatever reason you may choose) places the US second, behind Switzerland.

[Col. Crackpot]

Dark, you're not listening. If someone has the above mentioned average debt of $71,000 (most of it because of home mortgage no doubt) and ignore assets the comparason in NOT VALID. It ignores the huge difference between Secured Debt ( mortgage, car loan etc) and Unsecured Debt ( credit cards, personal loans, money you owe your bookie for last night's Knicks game). Also, it ignores the fact that you can have a debt and not be in debt.

[Guardsman Bass]

An interesting thing to consider is that the President has an MBA from Harvard--and check out the time when he got it. I don't think his decision-making is necessarily the result of any lack of intelligence but instead something which has infected the business world here ever since McNamara and the whiz kids took over at Ford.

Is there any fucked up thing in the last 40 years of the 20th century for which McNamara ISN'T responsible?

You've got to give some of the fuck-up credit to Henry Kissinger, at least in foreign affairs(aka Chile's Pinochet).

[Beowulf]

An interesting thing to consider is that the President has an MBA from Harvard--and check out the time when he got it. I don't think his decision-making is necessarily the result of any lack of intelligence but instead something which has infected the business world here ever since McNamara and the whiz kids took over at Ford.

Is there any fucked up thing in the last 40 years of the 20th century for which McNamara ISN'T responsible?

Um... 1967 Arab-Israeli war?

[Grand Admiral Thrawn]

Wow, Premiers declaring the sky is falling. Now point to the millions of Canadians uninsured.

I'll point to the fact that Canadians with money run to the US when they need something done because the wait for service in Canada is so long. Canadias come here for their operations, and we go there for cheap drugs.

In other words if you're rich, the American system works well. Thanks for proving my point.

[Col. Crackpot]

An interesting thing to consider is that the President has an MBA from Harvard--and check out the time when he got it. I don't think his decision-making is necessarily the result of any lack of intelligence but instead something which has infected the business world here ever since McNamara and the whiz kids took over at Ford.

Is there any fucked up thing in the last 40 years of the 20th century for which McNamara ISN'T responsible?

No, Ramsey Clark fucked some thing up too. And who can forget Bill Clinton's penis?

[tharkûn]

The problem with socialized healthcare is that is just one giant friggen monopsony. Like all other monopsonies it can leverage price reductions and use offsets in one commodity to subsidize another.

Right now the US does subsidize world healthcare to some degree, if a socialized country uses it market leverage to push for price controls on drugs then either the drug companies either raise prices somewhere else or they cut back on profit and business. The use of monopsonic practices by socialized healthcare has had a great enough impact that the US government is campaigning against it in their free trade talks, most notably with Australia.

Comparisons with Canada or Europe are a bit misleading first because the average American appears to be far more unhealthy than his Canadian or European counterpart and secondly because the US government appears to be far less cost effective than its European and Canadian counterparts. Most of the data I've seen suggest that the US is purchasing more Quality-Adjusted Life Years (added life expectancy due to medical intervention) than the rest of the world and doing so at a premium rate.

Socialized medicine would bring down costs, assuming leadership that didn't reek of incompotence, but it would come with its own costs due to monoposonic forces. US healthcare will never be as cheap as the rest of the world as long as the US is fatter than the rest of the world and willing to pay cash to make up the life expectancy differential.

[Darth Wong]

The problem with socialized healthcare is that is just one giant friggen monopsony. Like all other monopsonies it can leverage price reductions and use offsets in one commodity to subsidize another.

And this is supposed to make us decide against it despite the fact that the alternative involves higher costs and the human tragedy of uninsured families ... why?

[Darth Wong]

True, I was exaggerating a bit, well, a fair bit. But in general elective surgery as I understand it is for conditions which aren't life-threatening.

Not immediately life-threatening, but waiting weeks or months for surgery for things like breast cancer or partial coronary blockages is obviously going to cost some people very dearly.

Those wait-times are caused by the fact that when someone is deemed to have a more immediately life-threatening problem, they get to jump the queue. No doubt some Americans will point to the fact that under their system, rich people can always jump the queue, as if that is somehow a better method of prioritization.

I waited five months to get my hernia surgery because the hernia was not dangerous. When I was in there the night before my surgery, a guy came in, got examined, and got booked for surgery within 24 hours because his case was much more severe than mine.

[Loner]

granted, what you say may be true. My issue is this: why should the gold standard example of a replacement for our broken health care system be one that is only slightly less broken?

It covers everyone, and it costs less to boot. If someone offered a privately run improvement to the health care system that could deliver this, you would go apeshit over it. You're just pissing and moaning because your precious "private industry can do no wrong" dogma balloon has been punctured.

Couldn't it also be argued that companies would see that paying higher taxes is cheaper instead of the cost of providing health plans to each of their employees?

[The Dark]

Dark, you're not listening. If someone has the above mentioned average debt of $71,000 (most of it because of home mortgage no doubt) and ignore assets the comparason in NOT VALID.

Actually, a good bit is probably credit card debt, given that over 10% of household income went to pay for them.

It ignores the huge difference between Secured Debt ( mortgage, car loan etc) and Unsecured Debt ( credit cards, personal loans, money you owe your bookie for last night's Knicks game). Also, it ignores the fact that you can have a debt and not be in debt.

Very well, let's use Mr. Greenspan's comments on the current status of debt.

According to Chairman Greenspan, 13% of household income is devoted to paying the interest and principal on debt. 18% is spent on recurring expenses, such as "rents, auto leases, homeowners' insurance and property taxes." He was speaking primarily to comfort America that record numbers of personal bankruptcies was not a threat to the American economy. In this case, assets are worthless if they cannot be made liquid, and right now paying off what apparently is Unsecured Debt constitutes 1/8 of the income of the average American. I do find it odd that Greenspan would not explicitly discuss the oh-so-important difference between Secured and Unsecured Debt, but then, what does he know about economics?

[The Cleric]

I don't know too much about the Canadian healthcare system, so bear with me.

Is there any way in Canada itself that a person who COULD pay for it get their sugery as a top priority? Even if it was something completely elective?

[Darth Wong]

I don't know too much about the Canadian healthcare system, so bear with me.

Is there any way in Canada itself that a person who COULD pay for it get their sugery as a top priority? Even if it was something completely elective?

Sure; go to some other country. If you can afford some expensive surgery, you can afford a plane ticket; it's not as if the entire world is going to use Canada's system. They do not allow rich people to jump the queue here because it's considered a social injustice.

[The Cleric]

I don't know too much about the Canadian healthcare system, so bear with me.

Is there any way in Canada itself that a person who COULD pay for it get their sugery as a top priority? Even if it was something completely elective?

Sure; go to some other country. If you can afford some expensive surgery, you can afford a plane ticket; it's not as if the entire world is going to use Canada's system. They do not allow rich people to jump the queue here because it's considered a social injustice.

So if the US converted to the Canadian system, where would Americans nad Canadians go? Where's the next best location?

[Darth Wong]

I don't know too much about the Canadian healthcare system, so bear with me.

Is there any way in Canada itself that a person who COULD pay for it get their sugery as a top priority? Even if it was something completely elective?

Sure; go to some other country. If you can afford some expensive surgery, you can afford a plane ticket; it's not as if the entire world is going to use Canada's system. They do not allow rich people to jump the queue here because it's considered a social injustice.

So if the US converted to the Canadian system, where would Americans nad Canadians go? Where's the next best location?

Actually, the system varies somewhat from province to province. In the US, f it were like Canada's system, it would vary from state to state. Provincial governments are actually able to allow certain privately run medical activities if they wish, as long as they don't fail to deliver on the national health act's promise of universal coverage. It's just that my provincial government does not allow this at the current time. Maybe a conservative provincial government would, but nobody would ever allow them to jump the queue in the public system; there would have to be parallel pay-extra services.

[The Cleric]

there would have to be parallel pay-extra services.

That's what I was imagining. Do you think that it would be feasible to run?