It is fair to know how to do anything before you commit everything to it. The group I selected or pre-income generators; at or below average healthcare cost; and the future of the country.

Improved health in this group improves the foundation for education and economic growth. Remember, I'm talking about general comprehensive healthcare (GCH), not just Univarsal Healthcare (UHC) with the "Universal" definition given.

With UHC the participants aren't limited but the services can be. With GCH; preventive, all rehab, mental, illness, dental, vision, hearing, and injury services are available to all participates. That would be prohibitively expensive if we don't know how to do. To learn how to do it and pay for it...a limited group must start.

Today we can not even balance the Medicare books with insurance companies financing the balance of accounts. We are no where close to doing it without them, but we have to learn how to do without them to meet any standard of "Universal".

Bill"for what we are together"

Rather than posting the entire article here, I will refer you to a web page that outlines the benefits of the single-payer plan over the current for-profits system:

www.throwtherascalsout.org/health_care.htm

Jack Lohman
www.ThrowTheRascalsOut.org

Re: Universal means...? *
Bill713 on August 14, 2024 - 11:42am

Why do you give students an elite status with health care? Why should some one who can't or choses not to go to collete, pay for those who are priviledged. Is the one of those horrible "earmarks" that you keep complaining about? Is this another gift to the rich.. in this case their "trust babies"?

Certain things is society cannot be left up to profiteers because of the peoples dependence on these critical social functions... Healthcare just happens to be the biggest and most important one... others include energy, higher education, prescription drugs and legal services, and of course those things related to national security as they arise... all of these social functions must be regulated and subsidised by government with the price kept stable to the consumer during any instance of increased costs... Then with updated social security cards we can make basic food items, mass transit and community services nearly free to those that cannot afford to pay eliminating most of the fraudulant bureaucracy we see today... Earn Snyder
Author "$aving the bureaucracy - Killing the beast"
Modern Progressive Independent
http://www.appyp.com/fix_main.html

Universal in this context must be understood to mean all qualified people and not all services and products. Having said that, "basic" services meaning will itself be a very large debate.

I would like for us to take a stepwise approach to general guaranteed comprehensive healthcare. I'd like to start with covering all minors extented to the end of continous fulltime student/military status. When we know how to make it work financially and administratively, we can consider everyone else.

The assumption that we should dive into systems like UK, Canada, or Japan is not a good one. Those systems lack the incentives to drive progress in the technology and seek mostly to minimize patient cost and advance administrative cost. We must do better than that.

Somewhere a window of financial opprotunity must be maintained to keep the creativity coming.

Bill"for what we are together"

Too many people seem to take an 'all or nothing' perspective when it comes to 'universal health care'. Maybe the focus should be on doing a few things well, rather than many things badly. What would those things be? One possible list:

1) Develop the smart med card. This card records on a chip someone's medical records. When you fill a prescription, the card gets the info. This could provide the information backbone that takes records out the realm of chaos. It could save lives, given that many deaths are a consequence of not accessing relevant information in time.
2. annual screening. This need not require a doctor. That makes it relatively cheap. The most important screen is a blood test. This can determine cholesterol level, diabetes, and a number of other items. Universal testing will reduce unit price of the lab tests. The results can be loaded to a database, and the database fed to the smart card from any pharmacy or doctors office. When the data are transferred, a report can be printed out that alerts and explains any odd results, advises the person whether or not to see a doctor. Because there are only so many combinations of anomalous results, a computer program can do this. This is done now, to some extent by some labs.

When talking 'universal', one should think about procedures and ways of doing things that are of universal benefit, and that would not be acheived by insurance companies, drug stores, or doctors offices.

Beta-testing: any 'universal' care should be developed and tested in a limited area and the results thoroughly analyzed before deciding whether to implement it universally. The first space shuttle NASA built never flew. One needs to take a long view when making improvements. The present system has been declining in quality in some respects for a long time, and it will not be improved in a year or two.

Instead of all-encompassing, think incremental-universal.

Respectfully Submitted,

Sketch

Sammy,
You'll have to forgive my "parsing" of your sentence. I didn't assume that "cancer of the eyeball" would be detected by a colonosocopy, I assumed that since you were unable to construct the sentence unambiguously that you may not have been interpreting correctly what you heard. And again your statistical analysis needs help. You can not mix an anecdotal observation from you doctor with a scientific study by Harvard and come up with 1/2 of 1% cure rate. First if your doctors comment were true, which I doubt and you've provided no supporting evidence, it would be a "real world" observation. In the real world there is not 100% screening as is modeled in the Harvard study. So catching 1% of colon cancers via screening would probably be the result of so few people actually having the screening tests due to lack of health insurance. Also it was a "60% reduction in cancer incidence", meaning of the 100% of people who would have got cancer 60% now will not progress from polyps to full-blown colorectal cancer. So, if around 150,000 people will be diagnosed in 2024 (148,610 according to American Cancer Society), 100% testing would reduce that number to around 90,000 diagnosed cases of cancer. Again, you are just addressing the direct costs if we were to remove
Also, a colonoscopy should only cost around $1500. And if you did not have an abnormal test before your colonoscopy then your doctor was not following proper medical protocol, thereby needlessly driving up the costs.
But if you feel screening tests are so unnecessary, by all means stop having them. Although, somehow I think you won't take me up on that.

re: re: cost effective
Mhichil on July 19, 2024 - 11:56pm

When I stated that "1% of real cancers are early detected in this manner", it should have read "1% of real colon cancers ...". It didn't occur to me that anyone would parse the statement to indicate that a colonoscopy would detect cancer of the eyeball for example.

As for your study reference, It validates exactly what I was saying. Colonoscopy is the 3rd most cost effective method.

Of the 1% detected" This strategy resulted in a 60 percent reduction in cancer incidence and an 80 percent reduction in CRC mortality compared with no screening." means 60% OF THE 1%, were dianosed and treated resulting in 80% OF THE 1% dying early. A little over 1/2 of 1% cure rate.

The cost-effectiveness ratio of $92,900 per year OF LIFE GAINED is true of this 1/2 of 1% being treated as assuming the patient lived another 10 years treated compared with say 2 years with untreated cancer is obvious.

That doesn't change the basic principle that mass colonoscopy testing of the entire population with a 1% detection rate and a 1/2 of 1% cure rate is cost effective. It might be the right thing to do for the 1%, but certainly as a whole, its an expensive alternative to cost effective medicine and drives up the health costs for all.

Sammy, I work in Health Care. If you were charged $4300 for a colonoscopy then you were really getting reamed.

Your math on the "1% of real cancers are early detected in this manner" is all wrong. First, the doctor did not say (according to you) that 1% of all cancers were detected this way. That statement could mean many different things such as "99% of cancers are not detected early" which would in turn mean the treatment is not as cost effective, probably due to the high number of people without insurance. Or that most cancers that are detected early are other types of cancer (breast, testicular...). Either way, people smarter than me have found it to be cost effective http://www.ahrq.gov/research/jan01/101RA15.htm .

And these are just the Health care costs. When someone is diagnosed with cancer the costs on society as a whole are much greater. For example there is loss of productivity of the workplace for both the diagnosed and family (treatments, appointments...). You are also diverting health care and resources which could have been used elsewhere if they were not treating later stages of cancer.

The fact is there are hundreds of papers that address the cost effectiveness of prevention over cures. We pay thousands of scientists and researchers, who are experts in their fields, to figure out these kind of things. Doesn't it make more sense to listen to the experts over uncle Buford's anecdotal stories or a politicians sycophantic ranting?

Cost Effective
Greg Glover on July 19, 2024 - 7:59pm

Unfortunately, your probably right Greg. The shameful part of it is that we ran one of these leaches that call themselves lawyers for vice president 3 years ago.

In response to Sammy on July 19, 2024 - 7:25pm

Actually that is very cost effective. All it takes is one doctor to tell his patient, had you gotten a colonoscopy earlier, the cancer you now have could have been detected ai an earlier stage.

That patient will immediately contact his attorney and sue all related parties connected to his health care provider. The malpractice insurance carrier will quickly payoff to avoid a long and protracted civil suit, which will result in millions being lost.

my thought
Dual Citizen (Chadley) on June 29, 2024 - 4:30pm

You say "... pharmaceutical drugs they lower the cost per unit and as a result lowers the cost for the individual Canadian citizen". Americans pay more because Americans pay for the research to develop the drugs. Now, if all countries sponged off the work of the american pharmaceutical industry, they would be no american pharmaceutical industry .. and you would be either dead or crippled.

Two Reasons Universal Health Care Can Lower Costs
Mhichil on July 10, 2024 - 9:30pm

Actually, I dont know " we all know how much cancer can cost." Please tell us.

I do know I had a colonoscopy done last year. It cost $4300. My doctor told me that about 1% of real cancers are early detected in this manner. That means that 99 were done at a cost of $425,000 that proved to be negative. And since it was recommended to repeat in 5 years .. that amounts to nearly $1 million spent in the event that both prove negative.

It may be a good thing to do, but i'm not sure if these procedures are cost effective.

Healthcare Reform
Midniterise on July 19, 2024 - 7:11pm

Ok, you already posted that message last night. What exactly would you change and why?

There are many who think that we should avoid a national healthcare system. They will point to places where a national system doesn't work and say this is what we can expect.

I take a different approach to this idea. We comprise of the best and the brightest in the world. We have moved the world technologically to greater heights than it has ever had in its history. We fly to the moon and send spacecraft to the outer edges of our solar system.

So why are we afraid to tackle this problem?

If we do nothing then we can expect a collapse of our healthcare system and the economy in the next 10-15 years. We are now importing more workers than ever in history from our southern borders. They usually recieve poor if any health benefits. We have an aging population that will be pulling on our health system more and more. Our government is using the surpluses dollars in the Soc. Security system to fund current issues. If we don't solve this problem we will wake up some day with a health care system equal to third world countries.

If we can find true leadership in our local, state and federal government we can meet this challenge and bring about new growth in our economy while providing decent healthcare. When employers can’t hire workers because of the cost of healthcare then we are hurting our economy. When employees have to pay more and more each year for insurance premiums, then they begin to see a reduction in true wage earnings. Especially when deductions continue to move up for each individual.

When the insurance companies begin to fail due to lower numbers of people able to pay for insurance they will turn to the government for support. But why not help them? We have helped the auto industry when for years they have produced inefficent, gas guzzling road road hogs that have been mechanical junk heaps. The reward for helping the auto industry survive has been to watch them move plants to other countries and lay off workers.

If we ignore this issue we are going to pay much more and suffer greatly for indecision. The american people are beginning to see this and I hope come the next election will send a message to our political parties.

1. The previous post referred to the main cost reducer: Preventative Medicine. Catching many conditions early lowers the cost of treatment tremendously. Take colon cancer for example. Catching and/or preventing colon cancer consists of a simple colonoscopy and identifying and removing colon polyps. Not getting that simple preventative procedure can cause a polyp to turn cancerous and we all know how much cancer can cost.

2. A 10 cent Tylenol costs 50 cents because 4 people are never going to pay for the pills they get. Same principal with any consumable i.e. you pay 70 cents for a candy bar because half of them are shoplifted.

As a fairly inexpensive start, every citizen should be offered preventitive care at no cost. Think of how many surgeries twice yearly screenings would eliminate?

A recent report indicates that health care costs in Massachusetts are among the highest in not only the US, but the world (http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=38130). Yet the state has pledged to expand coverage to all of its citizens (http://www.metrowestdailynews.com/opinion/view.bg?articleid=134909).

If the United States has some of the best health care in the world should we work to expand coverage as broadly as possible even if the cost is great. Or, do you think expanding coverage is key to lowering the cost of health care? Perhaps some feel that the cost of universal health care might not be worth the benefits to society...

I am also anxiously awaiting to see what universal health care experiments will show. I wish the government would offer grants to a few different places and let them implement their own idea of the utopian system. Some will fail and some will thrive. As all states and communities have different resources and different challenges I would not want to see a "National" health care system. The best results will come from a diversity of ideas. What works in one place will not work in another.

To all those that think universal health care will be more expensive, that's simply not true. As more and more insurance companies are seeing, the prevention is always cheaper than the cure/treatment. I work for an "Integrated Health Delivery Network". We have an insurance company, multiple hospitals and many physicians offices. We also have an outreach program that provides heath care to the poor and homeless, why? Because identifying most these peoples health care issues early is exponentially cheaper than waiting for them to present to the ER and become inpatients. Hospitals make ZERO money on inpatient stays and Emergency Rooms in most metropolitan areas are hemorrhaging money.

http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2006/07/03/EDGOBIPTDT1.DTL

What do people think about the possibility of universal health care becoming a reality for the citizens of San Francisco? It would give Americans a glimpse of an American form of universal health care and allow some of us to see first hand its positive and negative effects. I personally look forward to seeing whether or not, if it passes, it is successful. If it is successful, what next? California, then the United States??? The next year could be quite telling of the future of the idea of universal health care coverage in the US.

To all I must state. I have the best of both worlds. I've had the privilege of growing up as a dual citizen with the United States and Canada and have had the opportunity see the both sides of the table.
I have tried both systems and am currently undergoing Medical school in Canada after weighing my options.
Even though the media may say that there are wait times in Canada it is not what one would seem. If you need life threatening surgery you are not thrown on long wait times in order for the procedure. They are done immediately. The only wait times that occur is through routine surgeries that take time and have waiting times.
As a whole, if you look at the prices paid for private insurance in the United States and compare it with the health tax that the average Canadian pays you will see that, per capita, Canadians pay far less for care. Not to mention, that since the Federal government (Canada) buys large supplies of pharmaceutical drugs they lower the cost per unit and as a result lowers the cost for the individual Canadian citizen. Canadians pay very little for prescription medication and are often only charged for the prescription filling fee (it would be free but it is illegal in Canada to give away drugs and alcohol). Seniors can fill any prescription that they have for a meagre cost of 2 dollars (the cost of the bottle).
However, we often have those who fight the battle that Canadians are forced to have mediocre care. I could only say that there is nothing farther from the truth. Canadian physicians have to go through more examinations before becoming certified and to practice. The only problem that Canada has had in past decades is that physicians have left for the states in order to make more money. Even though the price cap for physicians in Canada is generous, there are always those who want to be glorious and make more money. If the US were to adopt a price cap for their physicians the wait times in Canada would probably cut in half without the Canadian government doing much more than building more facilities to accommodate more doctors.
Now, the Canadian system is not the best, nor is it better than the US system of private healthcare. Each system has its own benefits and that is why both have survived the test of time. Although, The World Health Organization ranks two tier systems as being better for care. France has a two tier system which guarantees everyone basic coverage than allows for private healthcare to those who wish to afford it. The system allows for the best of both worlds, protecting those who cannot afford healthcare, and at the same time allows for those who want to have different services to have their right as well.

My suggestion is this: if you want universal healthcare, don’t lobby the federal government. Start the movement on the state level. Canada and many other western nations didn’t start their healthcare plans on the federal level. It started out as a small movement which showed progress. It is also far easier to target and get change done at the state level anyways. Officials are far more likely to see the benefits and be overcome by the populous. As a result of one state instituting a universal policy, the others won’t be far behind. They will see the benefits that a (insert state) has and will want their citizens to have the same benefits. Eventually the federal government will take what the states have done and eventually put federal funding and legislation behind it.

Perhaps the first comment should have been made in the Shoutbox where SMH told Don to grow up.
Perhaps SMH should have used a reply path to the comment you indicated in your text (TW). I see a lot of relevant items in TW's post that were not addressed. I also don't see that SMH's clever comment was relevant to the three items mentioned by Visitor.
(and at least TW wanted the bill paid.)

In support of SMH... his / her comment was just a quick observation (and one that IS VERY TRUE) not some exposition.

And yes there are postings in the thread that imply "free" healthcare one of several examples:

"TW on June 26, 2024 - 12:47pm
I cant see any other way of dealing with the problem other than having the government pay for our healthcare. "

SMH --- on topic and a relevant observation...

vry,

RET

I saw in another topic where you told someone to grow up because they were concerned with "off-topic and disrespectful debate" and now you come here and repeat something inane that was already posted on this page.
Aside from that I don't see how your comment was relevant to the comment you replied to and I don't recall any comments in this thread suggesting that healthcare be "free."

healthcare
Visitor on June 29, 2024 - 8:29am

If you think health care is expensive now, wait until it's free.

I see comments like "We subsidize unhealthy food instead of taxing it like cigarettes." I never see a definition of "unhealthy food" but does it matter? Milk doesn't do a body good if you are lactose intolerant. The main thing is food is an essential to life and cigarettes are not. I am not aware of anybody becoming ill from smelling someone else's french fries.
That doesn't mean we shouldn't encourage people to eat healthy but additional food taxes aren't the answer unless you are addicted to taxes.
Others say how drug addiction is a disease and should be treated that way, and while there is truth in that, you can't get addicted to an illegal drug unless a law has already been broken.

A big concern is that Universal Healthcare would increase delays for some procedures and that happens now partly because of malpractice. A mammogram misses a cancerous lump so the facility concerned about striving for the best care and with an eye on lawsuits replaces their machines with an MRI. Now they detect more and smaller lumps but expense and trained staff mean fewer machines and longer delays.

While I believe universal health care coverage is the solution to many of the problems with our current health care system, I also think it might raise other issues. It seems to me that with universal health care coverage will come longer delays for some medical treatment and appointments and, in some ways more importantly, a decrease in the incentive to become a doctor. With universal health care coverage it is inevitable that the profits on the health care provider side of things will decrease; money and profit seem a powerful incentive for enduring 12-16+ years of education and without it we are forced to wonder if the medical field would attract as many and as qualified practitioners. For universal health care to be a success, there must be plans to ensure prompt medical care is still possible and also that there are incentives to attract the best and the brightest into the medical field.

I cant see any other way of dealing with the problem other than having the government pay for our healthcare. Most businesses that americans work for charge higher rates or dont have healthcare benefits at all.Now if your making good money as a ceo or upper management or a business owner you may be able to afford a good healthcare plan.Healthy citizens are a vital part to a healthy country.I agree with those who dont trust our current government to handle this problem.I also agree with those who say we must fix a lot of problems with lawsuits and such that drive the prices up.I dont trust big business either who can lay you off at the drop of a dime.I'd like to remind those who say we should penalize alcoholics or drug addicts is that these are diseases.These types of diseases are that which cause a lot of other health problems.So these people need early treatment the most to become better productive citizens in america.What are you going to do just leave them die in the streets? I think education should be paid for by the government also.Just having these 2 things put in government control dosn't make us a socialistic society, it just makes these basic needs affordable to the rich and poor.I hope unity08 can give these things the proper discipline and oversight they need that we can give more opportunity to those who need it.

Of course the general public supports universal health care -- but we need to take a lot more responsibility for the real problems.

We subsidize unhealthy food instead of taxing it like cigarettes.

By insulating people from the true cost of care, we fail to curb abuse (both knowing and unknowing). Medicare in particular is horrible from this standpoint.

Malpractice suits award insane damages and the doctors keep practicing, while the high cost of malpractice insurance gets passed through in higher doctors' fees.

And of course, prescription drugs cost too much.

I don't see much value in nationalizing health care when the current system is already a massive money machine for certain groups. We should fix that first.

I agree. The Federal Government as presently constituted does not get my vote of confidence to administer the local animal shelter much less universal health care. Having said that, some type of partially subsidized health care is patently necessary for any civilized society. The question is what entity administers it.

Like education, I believe health care should be a state issue, not a
federal one. There should be a federally mandated "minimum health care" just as there is a "minimum wage."

There is such a regional diversity of opinion as to what should be covered that a one-size-fits-all federal approach is doomed to failure from the get go. South Carolina is the heart attack capital of the US. The South in general (Florida always excepted) has a problem with smoking and obesity, and would benefit greatly from a preventative care approach.

Just as an example, the South Carolina legislature has chosen not to make wearing a helmet manditory when riding a motorcycle. Why should the citizens of SC be forced to pay for injuries sustained by people who choose to ride dangerously?