Obama's Health Plan

[tooblue]

Hmmmmm, sounds really sad. The real shitter of it all is that, at the end of the day, having a kid is optional. I'm surprised it is covered by most insurances. Person chooses to have a kid and then is mad that they have to pay for it.

I'm not angry that I have to pay -- such a mischaracterization is asinine. Not only was I willing to pay but in fact for three years I thought I was paying $300 a month. Sike!

Trust me -- I pay for coverage now

Oh yah, and having children is optional. Of course society won't survive without people choosing to have children. When you are old and gray and retire who is going to take your place in the work force ... making the same salary taxed to the same extent so that you can drive on quality roads and have fresh drinking water come out of your faucets etc.

Yup, having kids is optional! Oh, I know we'll just let more immigrants into the country. Of course they will not be educated, nor will they be able to fill your position but ...

I can tell you've really thought your argument through

[wuapinmon]

I wonder if the aging population brings on problems of cost increase that are only exacerbated by improved medical technology and its associated cost. 50 years ago the best solution for a person with a bad heart was not as costly as the best solution today. I'm curious why no one has created a B level insurance plan. It think it might make sense to allow people to pay lower premiums and not get A level care unless they pay for it themselves.

Instead of e pluribus unum, this sounds more like Ego mos non partis per meus frater .

[Mormon Red Death]

Since Tooblue doesn’t believe in the reality of wait times being longer in Canada than in the USA I did some research that I thought I would present.

Here is a discussion paper.

Access to care is one of the most discussed issues facing the Canadian health care system.

Here is a study on wait times

1. British Columbia [3]
As can be seen by the data from British Columbia, waiting time varies by
specialty. For example, the median wait time for orthopedic surgery was 9.3 weeks, whereas the
median wait time for vascular surgery was 2.7 weeks. Similarly, the waiting time varies by
procedure as well, as evidenced by the waiting times for endarterectomy (3.0 weeks), cataract
surgery (9.4 weeks), gall bladder surgery (5.1 weeks), hip replacement (21.8 weeks), and knee
replacement (28.3 weeks).

What about waiting lists in the U.S.?
On average, U.S. citizens experience some of the shortest wait times for non-emergency
surgeries among industrialized countries, although the waiting times vary considerably by
procedure [11]. Furthermore, the short waiting times apply mainly to those who have insurance;
for those who do not, the waiting line is arguably infinite. Finally, the short waiting lists in the
U.S. should be tempered with the realization that the lack of universal healthcare in the U.S.
means less demand for the system. If there were universal healthcare without an expansion of
capacity, one might see how waiting lines in the U.S. could increase [12].
In a cross-national survey of sick adults in five countries, 40% of people in the U.S. said
it was either very difficult or somewhat difficult to see a specialist, compared with 53% in
Canada. Of the U.S. respondents indicating it was difficult to see a specialist, 40% cited long
waiting times (vs. 86% in Canada), 31% cited being denied a referral or having to wait for a
referral (vs. 10% in Canada), and 17% cited not being able to afford private insurance (vs. 3% in
Canada). 14% of U.S. respondents indicated they had a "big problem" with long waits to get an
appointment with their regular doctor, compared with 24% in Canada. Based on this data, more
Canadians than Americans report that waiting lines are a problem when trying to see their
physicians, although some Americans experience this problem as well. Also, more Americans
report problems with obtaining referrals and cost of care as obstacles to seeing specialists [13].

Here is an other Study (Only have the Excerpt)

Knee Replacement Waiting Times
Coyte, P. et al “Waiting Times for Knee-Replacement Surgery in the United States and Ontario,” NEJM
331(16) (1994)
Contact: Dr. Robert McMurtry (robert.mcmurtry@sjhc.london.on.ca)
Major Findings:
*Note: all U.S. data are for U.S. Medicare patients. The lower waiting times for U.S. patients show that a single-payer
system could be implemented in the United States with little or no waiting times for care.
• Median waiting times for orthopedic consultation were 2 weeks in the U.S. and 4 weeks in Canada.
• Median waiting times once surgery had been scheduled were 3 weeks in the U.S. and 8 weeks in
Canada.2
• Overall satisfaction with the surgical experience was similar in both countries (85.3% U.S. and
83.5% Canada).
2

http://www.commonwealthfund.org/usr_doc/1027_Davis_mirror_mirror_international_update_final.pdf

See chart on Page 25 of this Here is a study

Waiting time for emergency care was greater than 2 hours (base: used an emergency room in past 2 years)

Canada 42%
USA 29%

http://www.factcheck.org/askfactcheck/is_health_care_better_in_canada.html

Wait times are longer in Canada, but health and doctor quality don't seem to suffer.
It is true that wait times for physician appointments and non-emergency surgery tend to be longer in Canada, which has a government-funded, universal health care system, than in the United States. A study by the Commonwealth Fund, a nonpartisan research foundation that promotes improved health care access and quality, showed that 57 percent of adults in Canada who needed a specialist said they waited more than four weeks for an appointment, versus only 23 percent who said so in the U.S.

Now Tooblue might continue to believe that National Health Insurance as per his prerogative. I do however think the [URL” http://online.wsj.com/article/SB123811121310853037.html”]editorial[/URL editorial in yesterdays Wall Street journal said it best.

In Massachusetts's latest crisis, Governor Deval Patrick and his Democratic colleagues are starting to move down the path that government health plans always follow when spending collides with reality -- i.e., price controls. As costs continue to rise, the inevitable results are coverage restrictions and waiting periods. It was only a matter of time

[RobinFinderson]

Personally I find the whole issue of wait times to be morally appalling. The wait times argument comes down to this -- if poor people are given the same access to life-saving and quality of life improving medical procedures, wealthier people will have to wait a bit longer to get treatment.

Whether you are born into a wealthy or poor family should not be the basis by which we determine who gets life saving treatments and treatments that alleviate pain and suffering. If there needs to be rationing then we need a rationing/wait system that is blind to wealth.

[tooblue]

Since Tooblue doesn’t believe in the reality of wait times being longer in Canada than in the USA I did some research that I thought I would present.

Here is a discussion paper.




Here is a study on wait times



Here is an other Study (Only have the Excerpt)

Knee Replacement Waiting Times
Coyte, P. et al “Waiting Times for Knee-Replacement Surgery in the United States and Ontario,” NEJM
331(16) (1994)
Contact: Dr. Robert McMurtry (robert.mcmurtry@sjhc.london.on.ca)
Major Findings:
*Note: all U.S. data are for U.S. Medicare patients. The lower waiting times for U.S. patients show that a single-payer
system could be implemented in the United States with little or no waiting times for care.
• Median waiting times for orthopedic consultation were 2 weeks in the U.S. and 4 weeks in Canada.
• Median waiting times once surgery had been scheduled were 3 weeks in the U.S. and 8 weeks in
Canada.2
• Overall satisfaction with the surgical experience was similar in both countries (85.3% U.S. and
83.5% Canada).
2

http://www.commonwealthfund.org/usr_doc/1027_Davis_mirror_mirror_international_update_final.pdf

See chart on Page 25 of this Here is a study

Waiting time for emergency care was greater than 2 hours (base: used an emergency room in past 2 years)

Canada 42%
USA 29%

http://www.factcheck.org/askfactcheck/is_health_care_better_in_canada.html

Now Tooblue might continue to believe that National Health Insurance as per his prerogative. I do however think the [URL” http://online.wsj.com/article/SB123811121310853037.html”]editorial[/URL editorial in yesterdays Wall Street journal said it best.

I NEVER said the wait times are not longer. I only stated that in emergency situations there are no wait times. Where's the emergency stats -- not emergency room visit stats, that's not the same thing. Don't misrepresent my argument.

You mean a person that wasn't in dire need of a knee replacement had to wait 2 weeks in the US? While a Canadian had to wait 8 -- WOW, alarming!

Your 'evidence' proves that every person regardless of economic status has access to the same health care. Furthermore, I can cite personal experience where individuals are moved to the front of the line with no waiting because a condition might impact their quality of life -- which contradicts your so called evidence about wait times.

What are we talking about here? You are fear mongering. Wait times are longer in instances where quality of life is not threatened -- I'm not disputing that. But the moment quality of life or the life is threatened there is no wait -- whereas you would have us all believe that it's true for even emergency situations -- which again are not the same as emergency room visits!

I live here and access the system in question. I know more about it than you do. Sorry, but personal experience trumps internet links.

[Mormon Red Death]

I NEVER said the wait times are not longer. I only stated that in emergency situations there are no wait times. Where's the emergency stats -- not emergency room visit stats, that's not the same thing. Don't misrepresent my argument.

In the post above An empirical study found that 42% of canadians wait 2 hours or more at the ER versus 29% of Americancs. Obviously if someone is shot they aren't going to wait in Canada the US or anywhere else in the world

You mean a person that wasn't in dire need of a knee replacement had to wait 2 weeks in the US? While a Canadian had to wait 8 -- WOW, alarming!

Your 'evidence' proves that every person regardless of economic status has access to the same health care. Furthermore, I can cite personal experience where individuals are moved to the front of the line with no waiting because a condition might impact their quality of life -- which contradicts your so called evidence about wait times.

Instead of empirical evidence we should just go by Tooblue's experience. No offense to you but your own personal experience does not contradict an empirical study. This kind of "reasoning" makes you sound like an idiot.

What are we talking about here? You are fear mongering. Wait times are longer in instances where quality of life is not threatened -- I'm not disputing that. But the moment quality of life or the life is threatened there is no wait -- whereas you would have us all believe that it's true for even emergency situations -- which again are not the same as emergency room visits!

I live here and access the system in question. I know more about it than you do. Sorry, but personal experience trumps internet links.

They weren't internet links they were studies done to understand the problem. In the real world we don't rely on personal experience of Tooblue we run scientific studies.

BTW I'm glad you finally agree with me about wait times. By going to a National health insurance cost will increase. The only way to now limit those costs is to limit supply or rationing. You might feel ok with longer wait times but I don't.

[byu71]

Personally I find the whole issue of wait times to be morally appalling. The wait times argument comes down to this -- if poor people are given the same access to life-saving and quality of life improving medical procedures, wealthier people will have to wait a bit longer to get treatment.

Whether you are born into a wealthy or poor family should not be the basis by which we determine who gets life saving treatments and treatments that alleviate pain and suffering. If there needs to be rationing then we need a rationing/wait system that is blind to wealth.

I am wondering what other issues you think should be equalled out. How about education. Why should the wealthy be able to send their kids to Harvard or Stanford. There are scholarships and other things to help poorer folks get in, but the wealthy get in far more often.

Why should the wealthy be able to get safer cars. The middle class and poor should have as much right to drive around safely as the wealthy.

We also should do away with Country Clubs. Why should the wealthy be able to get access to tee times easier than the middle class and poor.

I could come up with a lot more I am sure.

Perhaps we should have a reequalization act. Every 8 years everyone has to through all their assets into a pot. The bovernment then divides it equally among all the Americans and undocumented. At least the divide between the wealthy, middle class and poor wouldn't get out of hand.

[tooblue]

In the post above An empirical study found that 42% of canadians wait 2 hours or more at the ER versus 29% of Americancs. Obviously if someone is shot they aren't going to wait in Canada the US or anywhere else in the world



Instead of empirical evidence we should just go by Tooblue's experience. No offense to you but your own personal experience does not contradict an empirical study. This kind of "reasoning" makes you sound like an idiot.



They weren't internet links they were studies done to understand the problem. In the real world we don't rely on personal experience of Tooblue we run scientific studies.

BTW I'm glad you finally agree with me about wait times. By going to a National health insurance cost will increase. The only way to now limit those costs is to limit supply or rationing. You might feel ok with longer wait times but I don't.

What the hell are you talking about me finally agreeing, Mr. proof. Go back and find a SINGLE instance where I stated there were not longer wait times for non emergency (life or quality of life emmediately threatened) services! You continue to misrepresent this issue in the hopes that people will not see your opinion as the fearmongering it is.

What are we talking about here? You would have us all believe that the wait times in the above mentioned studies is for ALL services including dire emergencies. There is NOTHING in your so called evidence that reports on wait times for true emergencies because there are no wait times in such situations. There are only marginally longer waits for care that is not considered life or quality of life threatening.

Contend with my above points, don't try to change your argument after you have been exposed.

My personal experience is more relevant than your studies because your studies occurred in 1994 and I am living and accessing the same health care system in 2009.

Question: If I am aged and suffer an accident which requires surgery to replace a hip or knee will I get the care I need in as quick as fashion as I would in the states?

Answer: YES

Question: If, in consultation with my doctor and due to discomfort in my knee or hip it is decided the joint should be replaced how quickly will it be before the surgery will occur?

Answer: In some but not all instances the wait time might be 8 weeks which according to ONE study conducted in 1994, on average, is a longer wait time than a similar patient in the US may experience.

The only idiot here is you.

[RobinFinderson]

I am wondering what other issues you think should be equalled out.

Education
Health Care
Public Space (we need more of it!)
Healthy Food

P.S.: When a wealthy Hollywood fat cat can cut in line in front of a poor child, when both need the same life-saving treatment, that is proof enough that the system has no moral leg to stand on.

[byu71]

Education
Health Care
Public Space (we need more of it!)
Healthy Food

P.S.: When a wealthy Hollywood fat cat can cut in line in front of a poor child, when both need the same life-saving treatment, that is proof enough that the system has no moral leg to stand on.

I could go along with health care, but not death prevention. Why should I subsidize anyone's heart transplant?

What if I choose not to have an expensive procedure that has a 50/50 chance of success because I don't want to spend money I could leave to my kids. Do you really think someone else should have access to my money so they can get the procedure?

I am all for everyone getting basic health care. If some really rich dude can afford to have a transplant I can't, that's life. It just isn't fair. The more people accept that, the happier they will be with their own circumstances or the more they will try to improve themeselves.

[Brian]

Personally I find the whole issue of wait times to be morally appalling. The wait times argument comes down to this -- if poor people are given the same access to life-saving and quality of life improving medical procedures, wealthier people will have to wait a bit longer to get treatment.

Whether you are born into a wealthy or poor family should not be the basis by which we determine who gets life saving treatments and treatments that alleviate pain and suffering. If there needs to be rationing then we need a rationing/wait system that is blind to wealth.

Life is hard. Wear a helmet.

[Mormon Red Death]

What the hell are you talking about me finally agreeing, Mr. proof. Go back and find a SINGLE instance where I stated there were not longer wait times for non emergency (life or quality of life emmediately threatened) services! You continue to misrepresent this issue in the hopes that people will not see your opinion as the fearmongering it is.

What are we talking about here? You would have us all believe that the wait times in the above mentioned studies is for ALL services including dire emergencies. There is NOTHING in your so called evidence that reports on wait times for true emergencies because there are no wait times in such situations. There are only marginally longer waits for care that is not considered life or quality of life threatening.

Contend with my above points, don't try to change your argument after you have been exposed.

My personal experience is more relevant than your studies because your studies occurred in 1994 and I am living and accessing the same health care system in 2009.

Question: If I am aged and suffer an accident which requires surgery to replace a hip or knee will I get the care I need in as quick as fashion as I would in the states?

Answer: YES

Question: If, in consultation with my doctor and due to discomfort in my knee or hip it is decided the joint should be replaced how quickly will it be before the surgery will occur?

Answer: In some but not all instances the wait time might be 8 weeks which according to ONE study conducted in 1994, on average, is a longer wait time than a similar patient in the US may experience.

The only idiot here is you.

http://www.commonwealthfund.org/usr_doc/1027_Davis_mirror_mirror_international_update_final.pdf

was published in May of 2007. But again Tooblue's personal experience trumps any study.

[RobinFinderson]

I could go along with health care, but not death prevention. Why should I subsidize anyone's heart transplant?

What if I choose not to have an expensive procedure that has a 50/50 chance of success because I don't want to spend money I could leave to my kids. Do you really think someone else should have access to my money so they can get the procedure?

I am all for everyone getting basic health care. If some really rich dude can afford to have a transplant I can't, that's life. It just isn't fair. The more people accept that, the happier they will be with their own circumstances or the more they will try to improve themeselves.

An equal baseline that cuts off life-saving services from the poor? The moral calculus of such a system gets grisly pretty darn fast. Consider an eighteen-year-old child, maybe still in his last year of high school, he is technically an adult, but has had not time or opportunity to accumulate money and privilege the way an old wealthy person does. The kid and the fat cat end up with the same cancer. The fat cat gets chemo and survives, but the kid dies for lack of treatment. Any wealthy society that sees no problem with this outcome is on a fast track to hell.

The organ market gets even more grisly more quickly. There is a huge moral hazard when you create a system where wealthy people have first dibs on organs that are harvested principally from poorer populations. A more equitable system would be this -- if a person donates viable organs to the organ market, his or her descendants should get first dibs on organs in the future. This would create a culture of organ donation, it would be far more equitable, and in the long run I think society as a whole would greatly benefit. But the alternative that you describe is practically cannibalistic.

[byu71]

An equal baseline that cuts off life-saving services from the poor? The moral calculus of such a system gets grisly pretty darn fast. Consider an eighteen-year-old child, maybe still in his last year of high school, he is technically an adult, but has had not time or opportunity to accumulate money and privilege the way an old wealthy person does. The kid and the fat cat end up with the same cancer. The fat cat gets chemo and survives, but the kid dies for lack of treatment. Any wealthy society that sees no problem with this outcome is on a fast track to hell.

The organ market gets even more grisly more quickly. There is a huge moral hazard when you create a system where wealthy people have first dibs on organs that are harvested principally from poorer populations. A more equitable system would be this -- if a person donates viable organs to the organ market, his or her descendants should get first dibs on organs in the future. This would create a culture of organ donation, it would be far more equitable, and in the long run I think society as a whole would greatly benefit. But the alternative that you describe is practically cannibalistic.

I think I have consistently said the first priority should be age. For instance, if there aren't enough organs to go around poor 18 year old gets priority over 80 year old rich guy.

[tooblue]

http://www.commonwealthfund.org/usr_...date_final.pdf

was published in May of 2007. But again Tooblue's personal experience trumps any study.

One of the studies you cited earlier was from 1994. Your study above is comparing 6 countries with data compiled over several years starting as early as 1998. The study is not an exclusive comparative of Canada and the US:

Yet, because these six countries have varying health care systems that serve diverse populations, the surveys offer insights for industrialized nations that—while they might have unique national contexts—face similar cost and quality issues. Comparing patient- and physician-reported experiences in these countries can inform the ongoing debate over how to make the U.S. health care system more effective and responsive to patient needs.

Cross-national surveys of patients and their physicians offer a unique dimension that has been missing from international studies of health care system performance, including the WHO analysis. When such surveys include a common set of questions, they can overcome differences among national data systems and definitions that frustrate cross-national comparisons. Since 1998, The Commonwealth Fund has supported surveys about patients’ and health professionals’ experiences with their health care systems in Australia, Canada, New Zealand, the United Kingdom, and the United States.

Again, you fail to answer my questions and insist on trying to paint me as an irrational raving idiot. You cannot contend with my arguments on the merits and instead choose to denigrate me. I have remained consistent in my comments. Wait times in Canada for non life or quality of life threatening health services may be longer but not excessively longer than wait times in the US. Your data bears this out. Furthermore, I will not stand by while the truth about immediate emergency care services is obfuscated in the name of fear mongering.