Effect Measure

How about Medicare for all?

If you have heart disease or diabetes and you are uninsured you are worse off than those who are insured by several measures. Those are the kinds of health conditions that usually worsen with age, too, so you would expect this to be a bigger problem for the uninsured near elderly. But they don’t worsen for this group because when they hit 65 in the US they are no longer uninsured: they have the near universal health insurance coverage called Medicare, and as a result their health improves. Those are among the findings in a paper in the Journal of the American Medical Association (JAMA) by a team at Harvard Medical School:

J. Michael McWilliams, M.D., of Brigham and Women’s Hospital and Harvard Medical School, Boston, and colleagues assessed the association of acquiring Medicare coverage at age 65 years with trends in self-reported health outcomes from ages 55 through 72 years for previously uninsured adults, especially those with cardiovascular disease or diabetes. The researchers analyzed survey data, collected from 1992 through 2004, from the nationally representative Health and Retirement Study, which included 5,006 adults who were continuously insured and 2,227 adults who were persistently or intermittently uninsured from ages 55 to 64. Changes in health trends were compared for previously uninsured and insured adults after they acquired Medicare coverage at age 65 years. The areas of health surveyed included general health, change in general health, mobility, agility, pain, depressive symptoms, and a summary measure of these, along with adverse cardiovascular outcomes. (via Science Blog [NB: not the same as Scienceblogs.com])

Before they were eligible for Medicare, the health of the uninsured near-elderly got worse faster than their insured counterparts, being significantly so by the time they hit 65. Those with cardiovascular disease and diabetes, however, reported significantly better overall health, mobility and heart disease outcomes after getting on Medicare. The improvement was so rapid that in a few years, by the time they reached 70, the expected difference in the summary health measures between the previously insured and uninsured had been reduced by half.

The implications are that earlier insurance coverage would vastly improve the quality of life for the near elderly. It would also likely save money, but the reason to do it is because it’s the right thing to do. Whether health is a right or an entitlement is a sterile argument. It is, however, a social good in the sense that a healthy community makes the lives of everyone in it better. I’ve got my Medicare card. But I had to wait until I was old to get it. In the meantime I spent a huge amount of money getting coverage. I’d have gladly paid for it in my taxes. I wouldn’t have had to pay 50% more for the same coverage because of the 30% portion of my private health insurance premiums are administrative costs to a health insurance company whose every incentive is to deny me coverage.

Here’s my simple 2008 health care reform proposal: Medicare for All.

Comments

  1. #1 Three-Fitty
    December 27, 2007

    It’s really very simple: The three branches of the federal government, and all citizens, get the same healthcare. With the health of themselves and their families at stake, the feds will find a way to make it work that we all can afford. And it will simplify everything by eliminating the profit that attracts meddlers who want to insinuate themselves into the system and parasitize it.

  2. #2 M. Randolph Kruger
    December 27, 2007

    And instead of that, we get the USGovernment in charge of healthcare. A government that does everything so well already. Taxes the crap out of us and will do that with a certainty to pay for this. It the shell and peanut game.

    Their health doesnt improve at 65 Revere. It creates yet more drags on the system. At 65 you are retired or are supposed to be. Now to pay for healthcare, they will have to go back to work to feed themselves. Social Security will account for every dollar taken in already in three years. So who are they going to tax but the people on Social Security to pay for it? Smoke and mirrors. This is the problem with the system now. Not enough young people to pay into Social Security to cover those people who are living longer but are no longer productive.

    Tax the over 65’s? You damned right they will. They do it now. Taxing old people has but one result. They will end up getting admitted to the hospital because they have no place to live, they have no food and above all they know how to work the system.

    All of these other nations that have done this are tetering even more than we are. The UK is constantly trimming the tree of what they’ll cover, they are raising the co-pays and the system is at best minimal in many places. Why do you think that Canada flies their patients to the US for care? Its not because they have enough staff or facilities is it? .

    There simply isnt any way to pay for it and especially now that there has been a credit crunch. Tax revenues are about to fall like a rock. I guarantee you that if we get into the health business you had better start learning how to speak Chinese.

    3.50-That is not true. We will end up with a two tiered system. One of course being mandatory to pay for those who will not work. This will tank the economy as bad as the Great Depression because all of the spendable income will now be in the hands of government rather than yours.

    If they were going to put it in, they should have in the 60’s. They didnt then and the reason for that was that we simply couldnt afford to have less than 1/3rd of the population supporting 2/3rds. Its just not going to work. Revere will say different but the plain simple secondary fact is that the doctors say they will double their prices for participation as they write of one crapload now. Then there are the number of doctors. We are some 32,000 short in Tennessee already due to the malpractice insurance mess. Where are those doctors going to come from?

    No sense in becoming a doctor any more. Its smarter to become a lawyer that will litigate the shit out of the system and cause even more tax increases.

  3. #3 revere
    December 27, 2007

    Randy: Medicare works. I know it from others and now I know it for myself. It’s a fact.

  4. #4 MoM
    December 27, 2007

    One of the things I always like is that theory that the private sector is so much more efficient than the government at anything. I grant up front that my numbers are old (late 90’s, early 00’s), but compare the overhead of medicare (5-7%) to the overhead of private insurance (25-35%) and then move on to your next objection.
    Last time looked, the executive in charge of medicare didn’t get compensation in the 8 figure range. (by a couple of orders of magnitude…)
    But the private sector always does it better. (if you’re rich)

  5. #5 M. Randolph Kruger
    December 27, 2007

    But Revere, it dooms the economy. Look I have never said it wasnt a good idea. It simply wont pay for itself. It puts government money into pine box in about 70 or so years if you are born today.

    The whole idea behind Social Security is and was that it was to ensure no one would be destitute at the twilight of their lives. Now because of healthcare they are retired, draining the system and when they go and generally messy and expensive we literally put that money into a pine box and put it in the ground. The GDP and GNP will slowly but inexorably be put into a whole.

    You talk of health infrastructure and costs a lot. It costs a lot to live and even more to die. Those people who would normally die in about 70 years are living longer, are non-productive in a general sense and they contribute nothing to the support of the system.They paid in thinking they would get a deal and they are now going to get screwed in the twilight of their years.

    As far as I am concerned the government should get out of social welfare programs entirely. They rarely work, those that do always have to have money increases and it contributes massively to inflation.

    To coin a phrase, “Read my lips” this is going to cause runaway inflation, healthcare rationing and finally a two tiered system just as it has in the UK, Sweden, Italy, France, Germany, Hungary, The Netherlands, Belgium and Canada. The poor are going to be shuffled into a corner, get what they can and above all they are not going to get what they think.

    Those that come in now with secondary private insurance get seen ahead of those idiots that think that this is their out.

    You will also give in one fell swoop the major companies in the US a single one time bonus of whatever their contributions for healthcare are. They will drop it like a hot potato. No reason to offer this as a benefit except to that elite group that you are always fast to put on the burner.

    Then there are the doctors that will accept it. About zero of the doctors in the state of Tennessee will accept it and when DC decides that they need to ram it down the states throats, they will remove themselves from the union. You have seen the starts of this in Mass, N. Carolina, S. Carolina, Georgia, Tennessee and Mississippi. Surprising that a good sized group in Mass have had enough already. Talk about leftist states and they were one of the ones that first started this movement.

    Then there is the problem with the constitution. Well, sorry but the only way that this can be done is with a mandate, mandatory participation. That is a taking, prohibited by the Consitution and unless Ruth Ginsberg clones out then it will be struck. Just as the WPA was in the 30’s. This is an attempt at nothing more than a takeover and people once informed will simply back away from it. Hard sell because of the costs and that pure bullshit that you pay for me and I pay for you is just that. Its because a huge group in this country already pay nothing, they will never pay a thing and this is a soaking of the productive population in the interests of what, propagation of the poor population?

    This will drop the US to third world status for sure. And I dont give one big rats butt about someone in this country and the low fetal birth weight and all of the general crap about the poor. They get everything free now and then because they cant get out of the hood because that same system trapped them in it, they resort to crime.

    You add in that the Mexicans will arrive in droves to get onto our newly founded healthcare and you will see a quintupling of taxes and a destruction of our economy in under 5 years

    I hear this UHC stuff all the time and no one ever comes up with a way to pay for it without raising taxes to an all time high.. all in the interests of ONLY healthcare. It aint in the constitution, nor is entitlements.

    Mom-Here is the difference. Its a definition and its going to be the key. IS HEALTHCARE A RIGHT OR IS IT A SERVICE?

    I dont find it in the Constitution, I dont find it in the Bill of Rights. I dont find medicare in there and I dont find social security either. Now that renders it a service and this is a pay as you go society.

    Kruschev said, “We will destroy you from within.” This will do it without a doubt and the disaster looms. Get this one wrong and the US will be run over like a freight train. There wont be one. Either we will lose the Gulf and the oil with it, or because we didnt do it right the Iranians take Pakistan and the nukes with it. Then they get to charge whatever they want.

    This isnt just about healthcare, its about every other thing we do in the US. It will cause state and federal tax increases to the max. I would say about 65% and the very second that its passed it will drop the economy like a stone. I dont like experiments with my health care. I dont mind paying for MY care. I do mind paying for SOMEONE ELSES. The assertion that someone else in the hood is going to pay for my healthcare is crap pure and simple. You turn around and cut all the limits on the income level to qualify and then I would sign on instantly. Otherwise forget it. That is to say that Johnny B. Hood, is going to pay say 60 bucks a month and I pay 60 bucks a month then no problem. But that isnt going to happen. The states are going to have to contribute, they will have to tax to pay for the remainder. You think of it. Negotiated rates. Well Hell they will just raise the rates as the purveyors refuse to negotiate as they do in the UK and Canada and when they dont budge, they raise taxes to meet the shortfalls. This is so stupid its ridiculous.

    Ever since the UK implemented it, its been in the red each and EVERY year. Sometimes they cut services, sometimes they taxed but the end result is that the HEALTH CARE IS RATIONED THERE! You have to find a doctor thats willing to take you on, he might be a good doc or a bad one but hey you might have to drive 70 miles just to go tot the doctor, AND YOU HAVE TO WAIT!!!!!!

    Try that on an abscessed tooth or a suspected cancer. Why do you think Virgin Atlantic makes so much money and Orlando is becoming the medical Mecca of the US?

    Jesus H. Christ

  6. #6 revere
    December 27, 2007

    Does the military pay for itself? Do the police? Fire? Schools? Aren’t we paying for medical care now? More than we need to? Waste of money, 35% for administrative expenses. We could wipe that out and not have a 23 year old clerk in Kansas City deciding on what the insurance company will or won’t pay for. We can’t afford not to have it.

  7. #7 R G
    December 27, 2007

    Comment to Mr Kruger

    Canada does not fly patient to the US for care because we can’t afford it. Our health plan will pay more for the same service in the US than in Canada. Why? Capacity. You have medical staff and equipment that are not in use. Our system is designed to run at full capacity and cheerfully exploits yours so it does not have to invest in infrastructure to cover spikes in need.

    How sad is that when your own citizens do not get the care they need?

    One of the cultural differences between America and the rest of the industrialized world is your relationship to your government. Health care may be reorganized and re prioritized in Britain and Canada but it is part of the social contract we have with our government. We are happy to complain loudly and vote out of office anyone who attempts to take away what we view as a fundamental human right.

    That is not to say that it is a static system. It changes constantly, just as medical science and public health initiatives change. And those changes are made with the consent of the electorate.

    Don’t let the complaints coming from north of the border fool you. Complaining about health care is a civic duty. It doesn’t mean we want to trade our system for yours.

  8. #8 Catron
    December 27, 2007

    Here’s my simple 2008 health care reform proposal: Medicare for All.

    The solution seems simple to you because you don’t know what you don’t know. Your childlike belief that Medicare-for-All would reduce administrative costs is a case in point. If you would take the time to do the reading you would see that the solution is anything but simple.

  9. #9 M. Randolph Kruger
    December 27, 2007

    Catron pretty much hits it. Healthcare is the ALL CONSUMING issue in these countries previously mentioned. Its front page on the London Times just about every day with an article or two. I have bombarded this blog before with all the shitgrams that are written about it by the media in those countries. It numbers in the thousands per year. It also totally belabors the point that I make about it. They cant afford it, they tax, retax, tax again and they still have to cut services and that boys and girls is rationing. You cant get in to see a doctor so they load the ER’s up.

    Besides R G they fly them because you DONT have the capacity else why would they be flying them. Thats a crock. It costs a fortune for you to fly them to the states and thats a typical answer that you get about UHC. It means that if we are at capacity under UHC you had better get your shit together because the US will be closed to medical problems of Canada.

    Revere makes a good point and its a constitutional one. The fact is that the public defense IS in the Constitution. I didnt see anything about the UHC or healthcare or poor or what have you in it. Fire departments are local problems. Revere what you propose ensures that the system would go broke very quickly because they would do everything to prove everyone wrong about it and that means bombarding the system with all sorts of procedures. That same 23 year old would be witholding the payments as they did here in Tennessee in the failed TennCare program. They ran out of money, the docs started closing their doors or refusing to care for the TennCare crowd. AND they raised their prices to cover the shortfalls. Micro answer to the macro problem… UHC didnt work because the state constitution prohibited this under the taking laws for a mandate.

    Just cause someone tells you its a good idea doesnt make it so. It is socialism pure and simple and once they get control of healthcare the government will call all the shots. Just as they do in all of those other countries. Is our system the best? Yep. It doesnt translate to care for the poor but who is responsible for the poor? Redistribution of the wealth. You made too damn much money, you owe it to someone else because they didnt do what you did like get an education and a job. Then when you are having a hard time making ends meet, someone just says those poor people over there are having a really hard time and they drop the tax bomb bill on you again. Fact is taxes do NOTHING to get the poor out of their troubles. They have to do it themselves.

    Hey if I were wrong we would only hear glowing reports, that there was never a need to raise taxes. It pays for itself right? For Gods sake they tax the pensioners income to pay for what they have already paid for. The old people are going to suffer the absolute worst because the inflation will eat this program alive. Give me a break.

    Catron in his Manhattan Institute reading doesnt take into account the runaway inflation that will be underway if this goes in. One dollar goes in and it takes government two to account for it. Very, very quickly because the retirees are going to bomb the system already in Medicare you are going to see cut after cut after cut. Lets just tip on out and demand healthcare for everyone. Then when it passes the purveyors will simply find out what the limit is and then raise their prices right up to it.

    Have you put a pencil to how many people would fall below that 82,000 New Jersey mark nationwide. I bet its more than 1/2. So everyone would be poor and below the level and therefore not have to pay jack. The healthcare would be provided to them. So you create the full on welfare state of the 1960’s. It only took 14 years for that to bankrupt us. Just about the time that Carter rolled in there the final bills started coming in. It finished us and we had to cut all the social programs out as the interest rate climbed to 21%. Big surprise. All of the other social programs will be out because there will be only one. UHC.

    To be harsh, those over 65 might just have to pass on out the door a little more quickly so they dont place too hard a burden on the kids and the grandkids for UHC. Volunteers please? Sure that might mean me but that also ensures that these guys dont suck the life out of the country or economy in pursuit of the all encompassing bullshit of UHC.

    What group does it really benefit? The poor? Who has to pay for it? Taxpayers. Who establishes what level that a person is poor at? The Democrats. Why the Democrats? Because no Republican in his right mind would ever try to pass this without a means to pay for it. Cigarette Taxes Hillary… You must be smoking some really good ones.

    As we all know that it cant be paid for because the population is now past its prime it should just be left alone. More than 1/2 of the population is going to be on Medicare in a few years anyway so whats the diff?

    The difference is that healthcare is a SERVICE and not a right. The military is not a service, its a constitutionally provided for item. The last goof ball that tried to cut the balls out of the military got his handed to him in Iran because there was no money to launch an attack against them for taking the hostages. We simply didnt go to the Olympics….. Duh, now theres a threat.

    Just saying UHC would work in this society isnt a fix. Its never going to PAY for itself. The fire departments are state and local issues. Do they provide a service or is it a right to have a fire department. You have to have them to get insurance. You have to have doctors to use healthcare systems. This one issue will tear this country apart like a two dollar watch and secession is just around the corner if and when they implement it. Mind that states have to contribute now. Do you think that your state taxes wont go up too because of it?

    R.G. FYI the states have to contribute a huge chunk to the federal government for healthcare of the indigent now. We are getting KILLED in the State of Tennessee right now and not by our own citizens. Its the Mexican illegals. They blew thru the budget in August for the entire year here at the Med and its the only indigent care facility in the area. You guys in Canuckland can kibitz but be aware if they make it here, they can make it there. You can put out your welcome mat and let them know that healthcare is FREE in your country and thats the rub. It aint free anywhere. Someone has to pay for it and this country even if we dropped most of the military budget it would NOT be able to pay for it.

    We lose this battle then we lose the country. Mandated participation is illegal under the Constitution and they’ll try to slip it in. But I can only hope that the Republicans, the real Republicans stop it.

    Every citizen in the US R.G. can get healthcare. It has a process that has to be followed but by federal law they can get healthcare. So what you are saying is wrong. They just arent going to do backflips to provide it. BTW the poor limit in New Jersey is about 82,000 dollars USD. Poor at 82,000….. I am sorry but when they establish that limit they will slowly push it down to the ground floor. Just as it is now with insurance with the limit of coverage. There was a proposal in the UK last month to dump UHC. It of course missed by about 30 votes or so I read. But its a heck of a lot closer than the 75 from six years ago. Slowly but surely they are figuring it out. Healthcare is a cash flow scheme and nothing more. It will not provide any more healthcare on the day of its demise than the people who arent getting it now. Full circle. It also might end on the day that a mushroom cloud starts to rise after a blinding flash.

    Might I remind you that Rome went politically and socially correct and they fell within 25 years after they did. There will be poor always and in varying degrees of it. If the US goes down I would suggest you guys up there learn Russian. They dont delude themselves in Russia at all. They are in an advantage position right now and they will and would exploit it. They would be on Canada like a vampire in heat.

  10. #10 JN
    December 27, 2007

    Let’s get specific about Medicare for All. The bill currently before Congress is HR 676, authored by John Conyers. The organizations that are most active on its behalf can be found here: http://www.guaranteedhealthcare.org; http://www.healthcare-now.org.

  11. #11 M. Randolph Kruger
    December 28, 2007

    Lets even get more specific. There are provisions Conyers/Kucinich for a complete take over of the hospitals. Oh sure, they’ll have to pay for them and that is what makes this a TAKEOVER of healthcare, a pork barrel and a cash flow program for socialized medicine.

    The assertion is that you and your doctor will be making decisions. Thats pure crap. It will be based upon how much money is in the till at the time. Thats where the rationing begins. So how to ration? You have to control the facilities is how.

    http://www.dailykos.com/story/2007/12/1/124741/456

    This is a left wing site and even THEY mention the illegal aliens.

    Unbelievable!

  12. #12 revere
    December 28, 2007

    Randy: dKos is a lefty site but not everything on it is on the left. Even you can register and write a Diary entry like the one you linked to. They don’t censor stuff. This commentary is not a Progressive view and in particular the question of whether immigrants should be eligible. They are community members (much as you deplore it) and their health affects the health of the community. I want them eligible.

    What you call a “complete takeover” has already happened but the take-over is by private insurance companies. Read the entry you linked to. In almost every specific it notes this is not different than the current system except who is administering it and that private insurance will no longer profit from it. The current system has a simple principle: socialize the losses and keep the profits private. That’s a right wing principle, not a Progressive one.

    The system is already broke, or at least the American people are going broke paying for it. Time to try another tack: the one that has worked for every other modern industrialized country and the one even favored by large corporations in the US. They are the ones at a competitive disadvantage in the global economy.

    Regarding the Constitutional issue. Of course public health IS in the constitution. It’s in the Commerce Clause, or so the SC has interpreted it. But supposing Defense weren’t in the Constitution. Does that mean you would no longer be willing to pay for it in taxes?

  13. #13 Ian Gould
    December 28, 2007

    “3.50-That is not true. We will end up with a two tiered system. One of course being mandatory to pay for those who will not work. This will tank the economy as bad as the Great Depression because all of the spendable income will now be in the hands of government rather than yours.”

    Yeah universal healthcare has been a total disaster here in Australia – that’s why our unemployment rate is lower than in the US; our economy and population are growing faster than yours and our budget is massively in surplus despite repeated tax cuts in recent years.

    There’s no need to construct lurid fantasies about what universal healthcare would do to the US – just look at all the other developed countries.

    Every single one of them has some form of universal healthcare. These systems re all different and none is perfect – but none of them have resulted in the economic disaster that universal healthcare would supposedly unleash on the US.

  14. #14 Ian Gould
    December 28, 2007

    I get the impression this debate has been running here for some time so I’ll just make a couple of observations.

    1. The US spends ca. US$5,700 per person on healthcare. The US government contributed around US$2500 per capita.

    2. Total spending AND total government spending are lower in those countries with supposedly less efficient public health care systems.

    3. Australians spend around US$2,500 per capita on healthcare of which the government contributes around US$1,600.

    4. Australians live three years longer than Americans; our infant mortality rate is lower and we have roughly the same number of doctors and patients relative to our general population.

    5. I’ve never seen this supposed rationing and I’ve also never seen the supposed throngs of the poor clogging our ER rooms for non-urgent care. Maybe that’s because in order to get government funding doctors have to agree to treat anyone who walks in their door and to treat the poor, the elderly and unemployed at a lower rate (which is paid in full by the government). This system is voluntary by the way, doctors are free to opt out. 99.9% of them choose to stay in the system.

  15. #15 Ian Gould
    December 28, 2007

    The source for my figures:

    http://en.wikipedia.org/wiki/Health_care#Economics

    Health care costs are growing even faster in the US than elsewhere.

    The choice really isn’t between some idealised free market and “socialised medicine”, it’s between implementing some form of government system now and getting your health care costs under control and waiting 10 years and having a back-door de facto nationalisation of the system as employers and insurers default on their obligations and Uncle Sucker picks up the bill.

  16. #16 peggy
    December 28, 2007

    Millions upon millions of Americans are waiting, with their lives on hold, for universal health insurance. We are the under 65’s whose spouses have retired but we must work on for the health insurance. We are the young adults who long to return to school, but must keep working full time for the health insurance. We are the entrepreneurs who must continue working for a corporation because our family needs the health insurance. We are the couple who would like to take a leave from work and travel, or the writer who wants to write a novel, or the person who would like to care for a sick family member, but we must continue working full time for the health insurance.

    America needs affordable, universal health insurance so that we can be FREE. Free to make choices about our lives, free to pursue dreams. Maybe we don’t have it because the corporations know that many of us will no longer be indentured to them.

  17. #17 M. Randolph Kruger
    December 28, 2007

    And everyone here fails to see what will happen if we do it. Costs have risen because of insurance companies and litigation. This will ensure that we have government insurance and even more litigation and costs will rise with every lawsuit. They got RIGHTS!!!! It will suck this country dry in under five years and the handwringing will begin.

    The Commerce Clause doesnt say that healthcare is a right Revere. Its still a service. It will be shortfall after shortfall and the military goes to pot as will Social Security. That would make you happy beyond all words right up until something happens. WHO are they going to tax to pay for it??????? It has to be tax based and it is a freely admitted takeover and taking. Sounds like communism is just around the corner. Conyers is a Communist in my opinion as are most Democrats. They are not liberals, they are elitists who want us to do as they say not as they do…Al Gore for one.

    Another thing is that this is all based upon the notion that oil remains where it is or lower. We are in the fight for our very lives on the other side of this planet. Pakistan is in flames and they have the bomb. Lose this game and we go as do the other Western nations. How do you think we are even maintaining the 90 buck a barrel mark? By implied and actual threat is how. Pull back on that and go to only a nuke response as we did under Carter and the Strait of Hormuz is closed for business at anything less than 200 a barrel. Totally unable to stop the Russians in Afghanistan for years.

    There isnt a person who is in a UHC country that is able to tell me that costs havent risen nearly every year. In response they have had to trim and tax, one or the other just about every year. Last year the UK had to ration and that was the exact word used by their health care head. Not my words, hers!

    If we do this all of these UHC countries had better wake up and smell the coffee. We are providing the military shield that they live under. I might remind you that in the years of great socialism and that refers directly to Jimmy Carter, we cut the military. Within a year of that the Russians took Afghanistan. They also sat directly on the E. Coast of the US completely uninterdicted with nuke boats. One was only 14 miles from Boston Harbor. We knew they were there but had no destroyers because they were laid up without parts in dry dock. So those radiation burns will be taken care of by UHC?

    Those countries are going to see massive rises in their taxes because this little experiment is going to do our military. They will have to fend for themselves. We will have three simultaneous disasters. First is that if this goes in the military budget will have to be cut. Has to be, no projections beyond 1-2% of the GNP show it even being remotely able to work. Second, how do they work Social Security in with a system thats all Medicare? Cant tax the poor and that is only on income in this country. The only income retirees have is investments and Social Security. If the markets go down and they will they will survive only on Social S. Cant tax falling investments, only income. So we end up with a inflation conundrum. Paying retirees S. Security, then taxing it heavily. Then they have to raise it because inflation takes away the buying power. The spiral begins.

    But already before that Social Security is going to account for every dollar in fact every five dollars taken in in six years give or take, then you want to add this UHC in on top of it. Government takes up all of the available cash suddenly and then you only spend when you have to…. The economy tanks.

    They have done this before under Carters socialist sweep. It wasnt UHC but it was socialism. It didnt take long for the economy to go to Hell. Two years, thats all. By the time the third year rolled around the word stagflation was being used and we got fireside visits in the Oval Office. But back to these countries. They began to flip out during Carter when the Russian Bear got hungry. 25 division into E. Germany, four combat brigades in Cuba and our friend Daniel Ortega took over in Nicaragua. Most of you dont know or dont care that Al Qaeda has established training camps in Venezuela. We are seeing things repeating themselves ….again.

    So we get health care and then our interests move to only nuclear responses to threats. Just as they did under Carter. We end up using a bomb instead of conventional forces. You either fail to see what will happen, or you will dismiss it and we get into yet another fine mess. Its a mess now and people dont think it couldnt get worse. I can assure you that it can and will if this goes in. You wont have a choice but to participate at the end of an IRS gun. You refuse to participate and the IRS will slap a lien on your previously well heeled self and sell your property on behalf of the poor people of America and the United States Congress. Now you can see my references to secession.

    This is going to light a firestorm off in this country like one that has never been seen before. Its great to have healthcare, but what will the true price be? We are the only superpower out there. Put this in and we will no longer be one and it will start a new arms race. Make a checklist of the things I said and start checking them off when they happen. There is NO way to pay for UHC without massive tax increases each and every year or cuts in services. It will account for every tax dollar taken in all by itself. Those taxes of course will have to come from Australia. And they have it so good there without being part of NATO.

    Ian G. With all due respect we have a population that by any definition that is at least 1/3rd poor. The 82,000 a year suggestion by the Democrats as making a person poor will make more than 2/3rds of it poor. They will pay nothing in either taxes or UHC costs. That leaves an aging 1/3rd to pay into not only Social Security, but taxes in general and now UHC. Sorry but the math simply doesnt work and the inflation rate will be astronomical. No one is more aware than I am that we are financing the wars in Afghanistand and Iraq with bonds. Okay you have to pay bonds back and they are not free money but its better than taxes. The make work programs of the 60’s only ensured that the poor are permanently enslaved now. They are reaping the effects of that. Permanently poor making even more permanent poor that will require that the level that pay nothing increases.

    All sorts of issues at hand. The religious right and government funded abortions will kill this. The insurance companies will drop like a rock as will their investments in the stock markets. The markets go too. This starts a ball rolling and every stock market on this planet will drop if Wall Street does. World wide recession at the very least. It also guarantees drilling in the ANWAR and off of the coast of Florida. Something dear to Revere.

    With all the money in goverment hands who is going to buy products? Who is going to buy the Japanese cars and the Chinese lead based toys? Zip! No spendable income. Its all in government hands. This is a suggestion of price fixing and when you do, the purveyors just raise it right up to the intake or beyond each year. Costs rise and rise and rise. Putin isnt stupid. He wants us to do this as do the bleeding heart liberals. There are severe ramifications that everyone discounts and dont follow thru with by thinking it out. The one thing that is immediate is recession within two years of implementation if not depression, thus putting more people on the government dole. The law is going to get a test in the Supreme Court if implemented as well. No provision and the Commerce Clause is in regards to a service. This will make healthcare a right. And again at what cost?

    Australia has a population of about 20 million. They dont spend much on defense, about 3%. They have only about 60,000 en toto for their military. In fact its smaller than most Asian nations. So please dont anyone tell me how good things are in Australia when Vietnam could knock them over in an afternoon in a fist fight, much less the Chinese.
    That fight will occur I can assure you and soon. Sooner if we drop our military spending. I dont like military spending but its a necessary evil. You can take it for what its worth and if I am wrong, then I will be just wrong. If am right, you will have healthy, fat Americans right up until the next BIG war breaks out. The Chinese are spending 8% that we know of. Call them them and tell them that they need better UHC.

  18. #18 Mark Glen-Walker
    December 28, 2007

    I always hear the claims that compare the administrative cost of medicare to private coverage. They usually state how Medicare is more efficient. Do these claims take into consideration that private health insurance companies manage hundreds of thousands of medicare recipients healthcare through medicare advantage programs? Perhaps the admin costs are lower because the costs are shifted to private health insurance companies.

  19. #19 Ian Gould
    December 29, 2007

    “There isnt a person who is in a UHC country that is able to tell me that costs havent risen nearly every year.”

    Yes because new and more expensive treatments keep being invented; because our populations are aging and because people keep demanding a higher level of care.

    I spent a fair bit of time in a public hospital as a kid back in the 1960’s and 1970’s. When I visit friends in public hospitals today, they look like 5-star hospitals.

    And yet somehow our costs keep rising more slowly than America’s.

  20. #20 Ian Gould
    December 29, 2007

    Hti the sned button too soon.

    “In response they have had to trim and tax, one or the other just about every year.”

    Umm, sorry to break it to you but the medicare levy, an income tax surcharge paid by Australians to partially fund the health care system has gone down in recent years as have general tax rates.

    At the same time, health care benefits have increased dramatically with the introduction of a safety net system to cap the maximum amount of co-payments any taxpayer has to pay.

    Oh and that $83,000 per year in the US isn’t per person -it’s PER FAMILY.

  21. #21 PFT
    December 29, 2007

    Over 50% of all health care costs are paid by government already since they insure and pay for 20 million government workers, 2.3 million prisoner population (highest rate in the world by far), not to mention 42 million under Medicare, 35 million under Medicaid, 3 million VA patients, subsidies for hospitals with unpaid bills treating the 20 million illegal aliens who took out sub-prime loans, etc Thats about 100 million people right there (some overlap).

    So covering the other 200 million, most of whom are relatively healthy relative to the people already being covered by government, seems feasible Especially when 40 million of whom are uninsured (20%) are likely to end up on medicare or medicaid when they get sick anyways.
    Keep in mind, those 40 million are not the same people year to year, a number of the 160 million find themselves uninsured for short periods between jobs.

    Imagine the savings from economies of scale if you had a single payer system for all 300 million people. Talk about paper work reductions, lower administration costs, the ability for government to negotiate lower health care rates given they have 300 million customers for the providers.

    How many businesses are leaving the US to escape the burden of HC insurance for their employees (premiums have increased 78% since 2001, CPI says inflation was 21% in that period)? We can not afford not to have a single payer UHC system. The system is broke. Some insurance companies are even reported to have some patients get treatment in other countries.

    Look at incomes today

    Median Household Income is 46K
    Median Personal Income is 32 K

    Health Insurance premiums for the average family are over 12,000 dollars if they have no employer paid insurance, and if they do they pay 3,280 dollars on average for their share (for a 45 yo individual it would be 5,500 on his own). Poverty level for a family of 4 is defined as 20,650, and 10,200 for the individual (are they nuts for both?). So deduct health insurance premiums, and whats left, well, you have credit cards to make up the difference, or you go uninsured, or you do not work and go on welfare.

    Average health care costs are 7000 per person, double what it is in Canada (some are 0 for many years and then jump as high as 200K). We all get sick and die folks, sooner or later. Just hope you are insured when you get sick. And if you can not work because of your illness, you end up losing your insurance if you can not handle the premiums on yoru own. So even some of those 160 million may find themsleves not as protected as they think they are.

    Frankly, the arguments against UHC are sheer idiocy. As for that valuable money some are so concerned about, it is a fiat currency made out of thin air, it’s only value is as a medium of exchange mandated by law . UHC can be paid for by taxing interest received by banks on their loans by 50% since the money they loan you does not exist until you borrow it, thanks to the brilliance of fractional reserve banking. That’s why the government does not mind deficits, every dollar of deficit can create as much as 10 dollars. No deficits = recession. No debt=no money. Interest payments, no problem, the banks just print more money for them to pay the interest.

    For those who worry that UHC will not be as good as their current insurance, do not worry. You can still get supplemental insurance that will give you more benefits if you get sick, private rooms, etc. Same as in UHC countries. Canadian companies offer supplemental benefits to employees as a perk, but the cost is a far cry from what they pay in the US for full insurance.

    When the banks get sick, government rushes to pay their bills with our worthless money, when people get sick and can not afford to pay, good luck buddy (even though you pay 3 times more taxes collectively than all the corporations).

  22. #22 Ian Gould
    December 29, 2007

    “Australia has a population of about 20 million. They dont spend much on defense, about 3%. They have only about 60,000 en toto for their military. In fact its smaller than most Asian nations. So please dont anyone tell me how good things are in Australia when Vietnam could knock them over in an afternoon in a fist fight, much less the Chinese.”

    Okay this I am going to respond to.

    Australia spends more on defence every year than China and around 30 times as much as Vietnam.

    Vietnam’s army consists of conscripts with Kalashnikovs and a few tanks the Russians left when they pulled out 30 years ago.

    They have NO navy and you may not have noticed but there’s quite a lot of water between Australia and Vietnam.

    Assuming they had the transports to even get their troops to Australia they’d need to get past our navy (equipped with possibly the best submarines in the world and front-line US-supplied sufrace combat ships) and our air force (which is about to upgrade from the FA-18 to the F22).

    Assuming they survive that, they’ll be fightign a numerical smaller force which is much, much better trained and equipped.

    Any landing would have to occur in northern Australia which is remote with poor communicatiosn and transport and which the Australian army has been focused on defending since World War II.

    How exactly do you expect the Vietnamese (who’d mostly be on foot) to cross the several thousand miles from a beach head in the Northern Territory or Cape York to South East Australia? How do you think they’d be supplied?

    Australia’s defences are quire secure, thank you.

  23. #23 M. Randolph Kruger
    December 29, 2007

    Ian you dont understand our system here. Its based upon your income taxes for the level of coverage. You are right its 82,000 for a family of four? Okay, so you know how many families of four dont make 82,000? Probably half maybe more. So if thats the limit then we are screwed. That level on down will pay NOTHING into the system.

    Then there are those already on Medicare. That will take this to at least 2/3rds of the country having to be paid for legitimately by 1/3rd. It simply will NOT work. Do you tax the pensioners on the money that they put into the retirement system in Australia? We do here. The average is about 24,000 between two Soc. Security recipients. Remember this already accounts for every tax dollar in about 6 years. The boomers are hitting like rocks in a pan now. Almost 1000 per day. Where is the money going to come from for that? Social Security is supposed to be exhausted by the end of 2012. The Dems response? Raise taxes. Government spending increases and so will the interest rate in response. High taxes and high interest rates will kill the economy itself. Also when you tax money thats already been budgeted in its a money mill and the money becomes worthless. Then they have to raise the taxes, the interest rates and then start pulling back on the coverage.

    As for the reference to the raising of the rates in Oz and the other countries. Nor is it for the newest and finest procedures and equipment. Far from it. The UK is hanging on by their fingernails with their system. I can list hundreds of references in their own papers, not mine. The rates keep rising. The costs keep rising and indeed they had to start RATIONING last year. Front page news on I believe it was the Times for months. Things might be fine in Oz. Good. But the umbrella if it goes in here is going to collapse and take the economy with it. Insurance companies will simply not have the money to invest and thats what has pushed the economy higher and higher for years.

    Take a look at what happened after 9/11, Katrina, Andrew and other catastrophic hurricanes. The markets tanked for upwards of three to five months because they had to pay out rather than take in. Chubb Group really took it in the shorts. They are still fighting in court out in California from the 1990 fires. But the end result is the same. We are talking about a huge inflationary bubble that will start to rise. Its already rising.

    This is nothing more than a redistribution of the wealth program and I am sorry to say that under our system, no one making less than 50 g’s is going to be paying anything as a rule. The states will have to raise taxes tremendously just to make their payments so infrastructure will suffer. They will promise the poor so many things to get it in that they will simply jump on the wagon. It costs 1 million a year to keep a person alive that has full blown AIDS in the US and in the hospital. EVERYONE will show up to get that knee done, that hip done, that transplant. No way the system can handle it. It cant handle it now.

    So the suggestion is we pay less and get more. Wanna bet? I have told my employees that I will immediately upon introduction of UHC lay 1/2 of them off because they will jump my taxes as a corporation to pay for it. The rates suggested by the Democrats is between 63-76%. Thats about a 20% jump. Guess they should have provided the insurance to their employees huh? Besides my guys and girls will be laid off because demand will fall by that much. The first year is going to cost triple the projections at least maybe as much as five times. In a way I hope they do, because it will blow the Democrats clean out of the water as the economy tanks. These guys are going to do themselves in, but likely take the country with it.

    Socialism in a capitalistic society. You make too much money. You should just let us take what you make and give it to someone else.

    BTW-Your assertion about Vietnam is wrong. They are ranked at about 9th by the CIA in 06. Australia is at about 22 as of 2006. They also have 600 T-55’s, 300-T62’s and the remainder is the very formidable T-72’s. They currently hold Cambodia as well. Their Navy is on a buildup and they are sucking up to the Chinese again.

    The Chinese are the biggest threat to Australia. Dont you think these other countries would join in if they decided to go south for the winter?

    Check out the CIA factbook. Australia is including its expenditures in with their military sales. Very nice people though.

  24. #24 Ellen Rice
    December 30, 2007

    I don’t think the current system is captalistic at all — it is a bunch of fiefdoms. Try and buy a “plain vanilla Chevy” style of health insurance. It’s not out there to be had. We do need a combination of personal responsibility AND available to be purchased at a reasonable price choices.

    It SHOULD cost me more if I smoke or am overweight. But I also should be able to pay the premium that a federal employee pays to get the coverage that a federal employee gets. I also should get a price list when I go for any medical procedure, so I can decide– just like I do at the grocery store — whether I want the deluxe, the grand, the basic or the bargain deal. If I want the MRI (which the ER doc suspects I don’t need but
    feels, thanks to lawsuits, that he should order) then I can decide, yeah for 2K or no, thank you for zero dollars. There’s nothing wrong with empowering consumers by offering real choices.

  25. #25 Ian Gould
    December 30, 2007

    “They currently hold Cambodia as well. ”
    That’ll coem as a great surpirse to the Cambodians.

    It certainly came as a considerable surprise ot me – and I’m a graduate in modern Asian studies.

    As for your statement about relative defence budgets:

    http://en.wikipedia.org/wiki/List_of_countries_and_federations_by_military_expenditures#Stockholm_International_Peace_Research_Institute_Figures

    Vietnam: $650,000,000

    Australia: $9,412,502,000

    I think the figures you were looking at were probably measuring defence expenditure as a percentage of GDP.

    Guess what, Australia’s GDP is much, much larger than Vietnam’s.

  26. #26 M. Randolph Kruger
    December 30, 2007

    Well Ian, I hated to do this and I didnt want to cite everything. But here it goes.

    http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&list_uids=10156208&cmd=Retrieve&indexed=google
    http://www.civitas.org.uk/pdf/cs08.pdf

    Here is Reveres 23 year old making the decisions about healthcare. The difference? The kid is now making more money than at the insurance company.

    http://news.bbc.co.uk/2/hi/health/251988.stm

    Here is where the doctors pipe up.
    http://observer.guardian.co.uk/uk_news/story/0,,2073633,00.html

    And a little deeper yet.

    http://www.wesleyjsmith.com/blog/2006/02/uk-sinks-deeper-into-health-care.html

    Here is where they are now saying umps, maybe we should just provide basic care and everything else you need to go to….. Traditional Insurance. So I guess it isnt a right?

    http://www.bma.org.uk/ap.nsf/Content/healthcare+funding+review~healthcare+funding+review+-+Mechanisms~healthcare+funding+review+mechanisms+-+rationing

    But here is someone who was in the hospital and had to deliver her baby herself. No midwives or doctors…. Nice!

    http://prairiepundit.blogspot.com/2007/08/rationed-health-care-uk-style-do-it.html

    I especially like the ones where they are written by Brit doctors. The BMA chief wrote an editorial for their rag but I couldnt get it to download for some reason….

    Take this one instead. http://www.longwoods.com/product.php?productid=17455&cat=337&page=1

    Here is a near UHC state. Oregon and what happened there. .
    https://www.rcplondon.ac.uk/pubs/clinicalmedicine/0604julaug/0604_julaug_ed1.htm

    Here is the one where you get your doctor and yourself to make your medical decisions. Well you just got cut out in the UK. Dumped on your ear in fact. Outta that hospital bed bunkie. You aint sick you slacker!

    http://www.guardian.co.uk/society/2005/jul/21/health.healthandwellbeing

    Now here is where they start killing people in the name of the good green? pound.

    http://www.timesonline.co.uk/article/0,,2-2041873,00.html

    But things are great in Oz… Well you have rationing underway, or you werent aware of it.

    http://www.mdhs.unimelb.edu.au/news/deanslecture/20jul07.html

    Hey, remember them bastard insurance companies? Well they just got replaced in Oz by them bastard corporations that are having to pony so much of their money for the UHC that they had to cut it.

    http://www.uow.edu.au/arts/sts/bmartin/dissent/documents/health/let_mja_1_6_98.html

    Funniest part of this one says you guys in Oz are heading in OUR direction for healthcare. I just about crapped when I read this one.

    http://wopared.parl.net/library/Pubs/RP/1999-2000/2000rp25.htm

    Managed healthcare… just like the US of A! OhmyGod!

    Here is the one where they freely admit that healthcare is rationed in OZ.

    http://www.cmj.hr/1998/39/3/9740647.htm

    Loved it of course..

    But look Ian I aint gonna keep beating you up here on this issue. Its clear what happens. Costs get out of control, people end up getting hurt. Just as they do here in the US without UHC. Its unfortunate but it would seem that Germany, France, UK, Italy, Sweden, Finland, Netherlands are all in the same boat and that is that the suppliers or corporations are gaming the system in the name of the good green….Kroner, Mark, Franc, Pound and above all the Euro. There is no difference between your system and ours except that we have a CHOICE not to participate here. Massachusetts just implemented a near mandatory paricipation program for people in that state. You have to prove you have health insurance to get a job. This will hit the Supreme Court I believe in about 2009 as it works its way up into the courts. Now understand Ian that I wish that it werent so, that healthcare would be free but its not. Someone HAS to pay for it. It pretty well socks a pensioner there just as it does here to have his only source of income taxed after he has already paid that money in and the government(s) from whatever country stole it, made interest off of it and then when you get it back they steal it again. Doesnt make sense.

    Revere is one fine dude and I admire him because he doesnt back down on this stuff. He really believes that it would be a good idea. Its like a war though, define acceptable losses. Would you lose OZ and its military in lieu of Healthcare? Some would say yes. Most of the Aussies I know are vehemently nationalistic. Foaming at the mouth types when it comes to it. Kind of like Tennessee. We volunteer more than any other state for military duty. We feel its necessary. East Tennessee sent soldiers to the North during the Civil War, central and west sent them to the south. But volunteer they all did.

    I really dont have any answers for this problem except that in my way of thinking that there should be an indigent/unable to work program of insurance. Just belly up and say what the F and pay for those who are deemed unable. Those are the ones I WANT to take care of. OTOH, I also want to see those people who absolutely refuse to work taking jobs at McDonalds or Arthur Treachers Fish and Chips and get reduced rate insurance. But it has to be provided by private insurance corporations and not government. It puts them into a pool, the state can contribute to it as should the USGovt. But not a government run program. They simply are too easy to steal from, to game and to really fuck the people that really need it. We have one here and she is losing the farm paying for the meds and care. But thats the system. They will take care of you if you are broke but not until you are. The idea being that you should spend all of your assets before turning to government.

    Not that I like it, but when you think about it the TennCare program here that bankrupted the state in under five years took that on and lost… BIG TIME! 500 million in a state with 6 million people in four years and 700 million in 7. It accounted for every dollar plus another 200 million that we took in. It folded, left the doctors in the lurch and quite a few folded up their tents in bankruptcy.

    Even Sweden is now starting to feel the pinch as its population ages. No Ian, it sounds really, really good. But when they pitch it as free then I have an immediate rub with it.

    I have 765 articles from the last ten years. Some news, some physicians, some nurses but all are telling the same story from every country now and the message is the same. Cant pay for it. Cant tax any higher. Cant defend the country. And there are other cants in there but you get the drift.

    Healthcare IS rationed in the US now. Its between the have insurance and have no insurances. They can still get healthcare but the hoops are high and they have to jump thru them to prove they are broke and cant pay. But this goes to the plain fact that it IS a service and not a right. We didnt have this in the 40’s or before. The corporations offered it as a hiring benefit. Then it got to cost too much. Now very few offer it. So is government the problem or is it the litigation? Probably both and surely in some cases.

    Bests.

  27. #27 Ian Gould
    December 30, 2007

    “Would you lose OZ and its military in lieu of Healthcare?”

    We don;t need to choose because – yet again, OUR SYSTEM COSTS LESS THAN HALF AS MUCH AS THE AMERICAN SYSTEM WHILE DELIVERING SUPERIOR RESULTS.

    Assuming we decided to match US defence spending as a percentage of GDP, we’d need to increase spending by roughly 1.5% percent of GDP – say $10 billion. Our current financial situation is such that we could do that without raising taxes and without cutting any other areas of spending simply by reducing out government surplus.

    In contrast, if we were to adopt the American model,government spending on healthcare would increase by considerably more than that.

    Look: ten years from now the US will almost definitely have some form of universal health care – and Australia will almost definitely not have been invaded by the Yellow Peril.

    Until then, I don’t see a lot of point in trading links to vague anecdotes.

  28. #28 M. Randolph Kruger
    December 30, 2007

    Ian-those are links to papers by members of the the Royal Academy, the British Medical Association and quite a few from your own equivalents. I wouldnt call them vague. Nor would I discount them. We would be trading one bad system for one that ensures a disaster and the only difference is that government would have themselves a new cash cow.

    Oh and I agree, 10 years from now more than half of the population will be under Medicare and its already such a fine example of UHC. Poor funding a poor program that will produce poor results. Revere says it improves their health. Okay, I’ll buy that. But to what end? They live longer and sock it to yet another socialist program, social security. The end result is the same, they have to raise taxes and decrease services on BOTH programs. Rationing…..

  29. #29 revere
    December 30, 2007

    Randy: I guess by this reasoning we should not support any preventive services. In fact a pandemic will be a net plus on the financial side as all those young folks won’t be collecting Social Security. So what’s the big deal?

  30. #30 Grace RN
    December 30, 2007

    I propose the following:

    1. For all people ages 0 to 21-Medi-caid.

    2. For people between 21 and 65-Medi-cover. Enhance the role that advance practice nurses play in providing basic, preventive health care and still manage to hold the line on costs. mandatory for pedicatric NP’s to be in all elementary and high schools to provide basic exams and health care.

    3. For people over the age of 65-Medi-care.

    Each plan covers eyeglass/dental/mental health/substance abuse.

    Medicare is not a publicly traded business product,there are no dividends to pay out, no shareholders to satisfy. It remains the most economic plan to administer.

    I detest the ads that tout ‘do you want the government running your insurance?’.

    They already do, if you have Medicare or Medicaid. So cut the crap and cover the gap-people like me-earning too much to qualify for medicaid and not 65 yet.

  31. #31 Grace RN
    December 30, 2007

    P.S.

    Imagine all the nurses who currently work for insurance companies and in hospitals doing utilization review now able to re-join the patient care system.

    I don’t want to hear anything about having a 50% tax rate. Add up the stupid taxes we now pay(local/state/city wage/state and federal income taxes, taxes on food, phone bills etc)-most of us are already at or over 50%.

  32. #32 M. Randolph Kruger
    December 31, 2007

    Good point Revere. In fact I think that if H5N1 comes the economics of what it really means would and will decimate healthcare, housing, the markets, Social Security, Medicare, Medicaid and business in general. It will become the glowing point of the spear and especially in the socialist countries into the government. Death blow? Maybe. It also if you think about it will ensure immediate drilling in the ANWAR and off the coast of Florida if its moderate but not a total balls up.

    Why? We saw the deflation in the economy from the WTC’s going down. Inside of two months we were practically giving money away at the Fed as things went south. But it was based upon the resilience of the economy. We knew it would rebound. This time around it might not. We wont know what we have until its gone. If the power grid snaps the days are numbered for a number of people. Quickly, the markets will fall apart on their own because we wont be able to transfer money, account for it, collect it. All things go stagnant to down. But we wont even know what down is because we cant communicate. Phones go dead at 3 days for residential, a little more for commercial areas. So what do we send to the OPEC to pay for oil? Paper? It will cause hyperinflation on the front end, deflation on the back end.

    Then if you use the Katrina/WTC’s scenario of deflation, the price of oil will drop precipitously. But our money is based upon the good greenie being worth something. Its been kicked back and forth of course but paper in a pandemic is worth what? Maybe paper and a few cents? If the Arabs and Venzuela and others suddenly decide that they want gold because its always the final exchange we use, gold could be the new form of barter. One super tanker worth for how many bars of gold?
    Our currency suddenly becomes worth nothing except for debts, public and private. We start drilling in both because we cant pay for the oil outside. It would take about 2 years to get several hundred rigs up and running. But then theres that currency crunch. Most of our steel comes prefab from other countries. There is going to be a Commerce Dept two step going on. Its anyones guess how it plays out.

    But back to the Social Security/Medicare system. We buy nearly all of those hospital supplies from Asia. Chunk of it from China. They will be holding onto the bond paper to what already? Paper. We could default on them or not, but I bet they would want gold too for all the gizzies we buy from them. Demand will fall as will their economy. They will want tangibles and not paper. They want to be able to buy oil with the gold they get for us for that badly needed stuff.

    Social Security has a COLA in it. What if suddenly they have to adjust it up even by 50%. Now we have a deficit making that paper worth even less. Medicare? How do you pay for the things that the oldies need with worthless paper? How about services? Its really all commodity based and suddenly there are no commodities. What do we do?

    Some suggested that we would revalue the gold. Well thats a start but I can see where the Social Security/Medicare dreams could get dashed against the rocks. Me, I never since I graduated in 72 ever thought I would see either so I have planned accordingly. Lots of tangibles that would get me and the family thru the mess. But a mess would surely ensue.

    If its a high CFR I think it might start to settle out in about 5-10 years. Not before. And you are completely right. The seed corn will be planted… but in pine boxes and holes and while not a drain on the system under Mediwhat, they wont be paying in either. That will make the plight of the oldies even worse because as a rule so far the 50 and overs have made a good showing against BF. We will survive long enough to see our kids die. The older ones will have to go back to their avocations before their retirements because the day it hits with a high CFR, the golf games are over. Else they wont eat.

    Grace-You are right. Many people in many states pay more than 1/2 of their income in reality in local, state, federal taxes. The military is prescribed in the Constitution. Healthcare isnt. Because of the high eligibility caps before they start having to pay they will put on this initially there will be an absolute barrage of people into the hospitals for every service, surgery, medicine thats out there. Dont get me wrong. Most will need it. But when that first set of bills come into the Congress there is going to be a GASP! They will immediately raise taxes again. Second pass they will drop the ceiling on those that pay nothing. Suddenly that free care becomes a cost center for them. But the bleeding will still continue. The UK has had an absolute monster problem on their hands since the late 90’s and how to pay for all these things that are UHC. E.g. witholding of treatments because in the eyes of government you are too far gone for them to pay for a new cancer drug. They simply wait you out. See the timesonline story from above.

    The one thing that is a given and admitted by the UK, Aussieland, Sweden, Germany and France is that this will lead to healthcare rationing. The UK is even discussing going to managed healthcare and only providing “basic healthcare” to the citizens. Back to insurance companies they go.

    I honestly dont have any answers that are feasible to insure the public. Its a money pit and I have said it before this will become the single consuming issue in the US if its implemented. During TennCare here in Tennessee there wasnt a single day for 5 years that didnt have something about it in the papers.

    In particular I dont want the US Government in all its wisdom to even think about hiring that 23 year old that was working for the insurance company prior to this to make calls about whether you are too far gone to get a treatment. Its never going to be a doctor/patient making the decisions. Once they go over budget the doctors are going to feel the heat to limit care, just as they are now on the indigents. Oh, they’ll say it isnt happening and never has. Thats BS and you and I both know it.

    The difference? Health care being a service is an elective here. You can pay for it or not. UHC is mandatory participation, screw you if you dont get what you should. Your condition is bad? Sue us and we will put you on the list. That is what has been happening over and over again in the UK and other countries. You have no rights under UHC and it has already started moving towards a patient bill of rights in the UK.

  33. #33 Mharb
    December 31, 2007

    My advice to Americans:

    Buy your health insurance from the same company that you buy your life insurance from, and make sure that your life insurance policy pays out more than a worst case scenario health problem. If a majority of Americans did this, it would quickly fix your healthcare system at least for those who can afford insurance.

  34. #34 peggy
    December 31, 2007

    Mharb, A big part of the problem is that millions can’t get insurance at any cost because of pre-existing health problems. These can be asthma, high blood pressure, diabetes, etc. Millions more get offered insurance at exorbitant prices for crappy covereage.

    Now that we can’t buy health insurance affordably, and often not at all, we simply must move to universal affordable coverage. It is scaring me that so many people can’t see this simple fact.

    Grace, I’m an RN who used to work for one of those insurance companies. It is a waste of nursing expertise, and another good reason to close down the gravy train for those companies. And your point about taxes is right on. We have no more after-tax money than those in countries with a better social net. Add it up – ten percent, at least, into 401K, money aside of kids’ college, the health insurance premiums, the copays every month for prescriptions, and don’t forget the added stress and worry living in a system where one feels very much alone and vulnerable should anything go wrong. What price are we paying for that?

  35. #35 M. Randolph Kruger
    December 31, 2007

    Peggy-We are paying for a system in revolt. This what we do here revolt.

    OTOH they are on the other side of the Pond too. Crappy care, none of the original tenets that this thing was sold under to them are being followed. Its not a doctor/patient relationship, its a what do we have in the till to pay for that doctor patient relationship. They pay in via taxes, they get to wait. By their own admission they are rationing it in a huge way.

    Orlando’s economy will fall apart if they put this in here. The aforementioned law that Conyers is putting in gives a proviso for a government takeover of all hospitals. They’ll compensate them for those hospitals. Then you are one step into communism. About the only thing that I hear good about their system is emergency response. After that its a murky quagmire of driving 70 miles (posted here) just to see a doctor that required a woman to wear a headress while being examined by a dubious quality doctor.

    Read those posts. Find me ones that say good things about it and I’ll read those two. The bad ones so far outnumber the good ones by at least 15 to 1. But I always suggest that all facts be in before making an irrational decision in a rational situation. No knee jerks. They put it in, they’ll be broke in five years IMO then those other outlays will be moot. You’ll be paying it all in as new taxes to the government.

    Forget college too. To get it, they’ll try to cradle to the grave that one too… Oh, and you have no house. We will build you one for free. It will be as big as an apartment in Tokyo but its free…..

    Cradle to the grave. That grave will be full enough soon enough.

  36. #36 M. Randolh Kruger
    May 29, 2008

    I just love this. UHC in the UK is going to finally for the first time be able to reduce the outpatient waits to 18 weeks…I wonder what you do if you need follow on treatment? Wait another 18 weeks I guess.

    It says up til now, more than half the population of the UK waited for MORE than 18 weeks to be treated under UHC.

    Jesus H. Christ…. At least I get to bitch if I am paying directly for it.

    http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/nhs-set-to-meet-target-of-reducing-waiting-times-to-18-weeks-836750.html

  37. #37 revere
    May 29, 2008

    Randy: I don’t think you understand. It also took me FOUR MONTHS to get a routine appt. with my primary care provider. And I pay through the nose for the privilege. And i”m lucky. I HAVE a primary care provider. And I’m a doctor!

  38. #38 M. Randolph Kruger
    May 30, 2008

    Ah but I do Revere. Instead of an individual getting care, he just becomes a number in the mill. And you get to bitch about it. You are likely in the same boat as TN, we are 8000 MD’s short here starting in 2012. Biggest reason not to become a doctor? Malpractice insurance.

    These are outpatient services as well Revere. If it aint an emergency then you can be assured under UHC that it will not be treated as such.

    But I just want an informed public to make the decision rather than someone telling us its a great deal. Its not. The idea that I am paying now is one thing, but when 1/3rd of this country gets on the medical dole it will bankrupt us. 2/3rds cannot support the 1/3rd. Its just math, not a snarky position. Its only taken them 60 years to get to a less than 18 week wait? Damn, thats progress.

  39. #39 Lea
    May 30, 2008

    When you say “Jesus H. Christ” MRK you remind me of my abusive step-father.

  40. #40 M. Randolph Kruger
    May 30, 2008

    Sorry Lea if you had a problem there. My aunt did six years for taking my step uncle out for abusing my female cousin. No one knew. If we had, we would have been running tag teams on the guy and waterboarding wouldnt have been on the list of selected suffering. Things like this are handled a bit differently and generally the courts dont get involved because no one knows until its too late.

    “A Time to Kill”?

  41. #41 paiwan
    May 30, 2008

    Lea and Randy:

    I was very sorry to read Lea’s anger and pain. I can not assume that medical people like Lea could have been able to handle this easily. No one can move on without pain. What I am sure is that once people has gone over and moved on, then he/she becomes more competent and thoughtful person. I hope that I am right for Lea, right?

  42. #42 revere
    May 30, 2008

    Randy: There is no evidence that the doctor shortage has anything to do with malpractice insurance premiums. There are shortages in specialties where the premiums are not high and no shortages where they aren’t. Moreover incoming medical students know nothing of malpractice premiums and don’t pay any. That is just an insurance company talking point. Your pal Bill Frist just wants immunity from negligence. Notice in the article, the people in the UK (e.g., the Conservative Party) compare their UHC system unfavorably with the Continent. None of them compares themselves to the US, which virtually all Europeans think is the worst possible outcome.

  43. #43 Lea
    May 30, 2008

    Certain words or even one word can trigger a past memory paiwan.
    No anger, just balanced hate. (enough said, thank you).

  44. #44 Monica
    March 22, 2010

    I am on Medi-Caid. I don’t qualify for Medi-Care because I don’t have enough “quarters” of work. I WAS SICK!!! HOW DO I GET ON MEDICARE??? I’M DYING HERE. M-A-Y-B-E
    T-H-A-T-‘-S W-H-A-T T-H-E-Y W-A-N-T! cHEAPER THAT WAY. And, YES, I DID WORK BEFORE MY DISABILITIES A-N-D PAID
    T-A-X-E-S!
    I WISH I WAS RIP VAN WINKEL AND COULD NOT HAVE TO DEAL WITH THIS BS FOR A L-O-N-G TIME!
    AND TO A-L-L OF YOU, WHO ARE IN W-O-R-S-E SHAPE THAN ME, i’M SORRY, TAKE CARE, HOPE THINGS IMPROVE (I’m trying!!!) and maym you Higher Power (if you have one) find blessings for you. Smile at least once a day and find something to be grateful for.
    God bless.

  45. #45 Monica
    March 22, 2010

    HAVE COURAGE (IT’S NOT THAT HARD-PRACTICE AT HOME FIRST IF YOU HAVE TO. ASK A STRONG FRIEND TO HELP!!! SPEAK OUT!!! BE BOLD!!! YOU HAVE A RIGHT TO VOICE YOUR OPINION!!! DON’T BE A MOUSE…BE A LION!!! ONLY THE S-Q-U-E-A-K-Y W-H-E-E-L GETS HEARD! HANG IN THERE!!!

  46. #46 Paula
    March 23, 2010

    Monica, I understand, and the blessings you offer others here is appreciated. Wish I could be more helpful–the division between those “deserving” of Medicare and those tossed onto Medicaid is part of the big problem with health coverage here.

Current ye@r *