National health system in Australia: heading for a fall?

Revere: Information relevant;

a) We are three weeks out from a Federal election, and everything is being exaggerated.
b) In Australia, the Federal constitution specifies that the states control health. At the moment all state governments are Labour (=Democrat). The Federal government contributes money for health, but has no constitutional power to control how or where it is spent.
c) The Royal North Shore hospital (about which most vitriol is currently being cast) is in the middle of one of the wealthiest LCP (=Republican) Sydney constituencies.

I had occasion to attend a Canberra hospital recently for a minor problem. I obtained reasonably speedy (40 minutes) to see a doctor) and professional attention. My daughter is finishing nursing, she has no horror stories (well none relevant to these issues).

I suspect that if you read "The Australian" as well as the SMH you might get a more balanced view.

bar: I get a slightly different picture from Impacted Nurse, one of your own emergency room nurses. Good and depressing reading. Check it out.

Its not a slam Revere but we have private health care here except for the Medicare people and VA. Both are money pits. One is forced onyou by the Federal government, the VA is part of the enlistment package. But its like looking at two ends of the pole. One starts out heading towards the middle, the same from the other and we end up dead center. On one hand you have people who cant afford it unless they drop the HBO and Cinemax (aint happening), and the ones that have private insurance where things are not covered. The docs are in the middle and they hate calling and asking for permission to do tests and when we get them back on both ends of the gammete, they are wrong.

So if you are covered and you have to wait until you die to see someone and thats only to pronounce you dead, thats UHC. If you have to wait to see someone and get permission to do a procedure and you die waiting, thats actionable. The difference is based as I have said before. The Aussies apparently thought it was a right, paid for it and now they dont get those rights. Here and now, if we dont get seen and we die then the family can sue. I dont know and Bar or Jonny can pipe up anythime. Do you have litigable rights under the Aussie constitudion if someone hits the bag from negligence? Or is it more of a deal that if everyone was being seen as quickly as possible?

As for the impacted nurse... I am having a hard tiem deciding which side of this she is on.

Randy: "So if you are covered and you have to wait until you die to see someone and thats only to pronounce you dead, thats UHC."

No, that's the US health care system. That doesn't happen in Canada or France or Italy or Australia other places with UHC I know of. But it happens regularly here for people without insurance.

So you get covered and you die too Revere. Canada sends people to the US all the time and there are major cases where people died under UHC. They certainly are told by government what procedures they are going to cover and not. Nor do they get the latest drugs. Its about the same for both after you look at it. The only difference is that I will have to pay for someone else and not the other way around because we have a poverty line that is established by a bureaucrat or the Democrats.

Both are a disaster, but I shouldnt have to pay for 40 million new dependents. I am a little short right now. How about they get a job and cut out all of the unnecessary and buy insurance? With a 4.7 unemployment rate which is better than Clintons and Reagans, they can find a job. Insure though the kids, but not people making 82,000 a year. Thats crazy.

M. Randolph Kruger: "Canada sends people to the US all the time and there are major cases where people died under UHC."

What a horribly useless statement. Is this supposed to make us think that the alternatives do not? ANY system has failings.

You obviously need to examine the life expectancies and infant mortality rates. US 'health care' is criminally low considering the costs involved. UHC in Canada, although a wedge issue, is doing well on the global scale. Private health care only allows the rich to the front, it doesn't change the length of the wait.

We need to give nurses the respect they deserve. Considering the geographical scale of Canada, its low population density and aging population, we do extremely well.

The Canadian health care system is having problems because the various governments (provincial and federal) in the 90's balanced their budgets by cutting health care funding instead of biting the bullet and raising taxes. It is still almost as good as the US system in terms of wait times (look at the actual stats, rather than the talking points) and better in terms of outcomes. Oh, and it costs half as much per person, with a lower population density. Even the people who complain about UHC up here want a two-tier system, where you have the option of paying extra to get into a shorter line, rather than abolishing it.

By the way, you may want to look into the stats on the money Canada's healthcare system loses each year to people who come here for treatment, go home and don't pay. The boys who pretended to be "feral kids" come to mind.

Well Linzel I'll forgo my usual cites lists for the sake of brevity. The Canadian health system is starting to come apart too. An aging population cannot pay what they make on the social system, back into the system without there being an economic collapse there or here.You are indeed like the US in that you have deadbeats... Wait till the Mexicans show up on your border-they have bankrupted our county budget already and our public health facility is about to close. Their answer? Raise taxes.

Once they feed on us they will be up there. They dont even have to swim it in the summertime to cross the border. We have a problem in the US that if they implement something like this the doctors will bail out too. They cant make it on what they charge now and pay their malpractice insurance. I quizzed every doctor I know that I have seen in the last year and they all say it will be a disaster. The older doctors said they will just retire. Dentists (3) told me no way. One heart specialist, one neuro, one spine and my favorite female family GP.

They said they'll be private and stay that way because instead of dealing with some adminstrative person in an insurance company, they'll be dealing with an administrative person in government. Not worth it and plenty of people out there that will shuck out of the system.

Costs would initially drop for John Q. Public and then it will rise incrementally until the GOVERNMENT gets all the available spending money in your pocket. No job growth with that. The poor will increase their share and two-tier and rationing will result. Their kids will be having to pick up the tab for Social Security, UHC and general taxes. Can someone explain to me how in hell they plan to pay for it? Tax the rich? There arent enough of them to do it and its based on progressive income taxes. They simply will move everything offshore. Tax the corporations? Yeah if you want to shut down the economy. You think they are going to allow their costs to go off the scale? They'll move what manufacturing there is to Honduras. Tax the middle class? Yep, and it will shrink because the poverty line will rise and rise and rise.

Wonder why they are trying to dump it in Oz? Probably because like us its now moving into the older people and they are costing more and more to support from a health care standpoint. In Canada there was a MP that was trying to prosecute people for seeking outside healthcare. Its a takeover, socialism and likely very illegal under our Constitution. Nothing in it says that life, liberty and pursuit of happiness will be provided for you. NOR does it say that word ENTITLEMENTS in it. This could become a constitutional showdown issue in the courts and if they lose, not only will they lose this one but it ensures that the tax issue in general comes to a head....finally. The idea being that we (some of us) are too successful and that we should work to support those that dont, wont, and in I read about 3% of the population ...cant. I have no problem with the latter. Those who CANT get insurance then their particular states must provide it for them at a reasonable cost. Reasonable is dictated by the government of course.

Remember I am in the Poor South. I have family (cousins) who make more on welfare than they do going to work. I also have family that are VP's in the largest corps. in the South. So someone tell me or show me where it says in the US under its laws that we owe anyone else a living. They take it from the rich (rich by whatever ambiguous standard there is that month) and give it to the poor.

Clintons definition just as he left was that a single mom, with three kids making 50 K a year is rich! Uh-huh. I rank that right along with UHC and the dumbasses that they will balloon into the size of government to deal with it. Can you imagine how many people it will take just to manage it? Someone is going to have to pay for it and it wont be 40 million Americans. It will be 175 million Americans that will drop to 125 million Americans in 10 years then 73 million in 15 then like 55 million in 20. Thats the peak of the baby boom. EVERYONE will be on the dole. S.Security, UHC, Medicare, Aid to Dependent Children etc. That 40 million will grow up to basically only understand welfare and not jobs and the standard of living in this country will drop like a rock. It will also tank the stock market. No free spendable income means no investments. They will be taxing the shit out of everything.

Education... down the toilet. No money for it. Its all going to go to healthcare. Revere is right but for a different reason about the US being a 3rd rate nation in 15 years. It will be because we have become a socialist state in a capitalistic society. I think the last time that happened was when Jimmy "Gimme" Carter was President. Couldnt fight a war because there wasnt anyone to fight it. Nor were there parts for aircraft and aircraft carriers sat in dry dock for months waiting for the money and, bloompf there goes Afghanistan, and Iran. What does Canada do when the Russians are coming?

Yeah, UHC...thats the ticket. It will bankrupt us in under 10 years for sure and they'll raise the taxes, then the interest rate as the government becomes progressively more insolvent, jobs will go and there goes the game.

History repeats itself. Print this off and save it for the future. See if it doesnt come true if it happens. With all due respect to the Canucks, they'll have to start building up their military. We wont be there this time around. Too expensive.

Jason.... Biting the bullet might really mean that this time around.

"Even the people who complain about UHC up here want a two-tier system, where you have the option of paying extra to get into a shorter line, rather than abolishing it."

Hey Jason - dont speak for me!! I dont want a two tier system!! There are MILLIONS of us here who are not that selfish!! I dont mind waiting for a couple of hours with a non-urgent problem provided the wealthy have to wait alongside me!! I would feel VERY guilty jumping the line because I happened to be able to afford to do so, if others less fortunate were not being seen!
I dont know of a SINGLE case of anyone with a life threatening emergency condition who didnt get seen immediately - I went to the front of the line in emerg with a pulmonary embolism a year or so ago in Peterborough Ont - absolutely no delay, great service! I am glad I live in Canada where we cherish such important social ideals!

"Yeah, UHC...thats the ticket. It will bankrupt us in under 10 years for sure and they'll raise the taxes, then the interest rate as the government becomes progressively more insolvent, jobs will go and there goes the game."

I'm guessing you're not an economist by training. How can it be possible for Universal Health Care to bankrupt you if it costs half what you are currently paying per capita? Instead of paying money to the insurance companies, you pay half your usual subs to the government as tax, of course you may have to pay a little more than half, maybe 75% of what you currently do, to pay for those that can't afford it, but you're still saving money overall. Surely this is obvious right? As far as I know every country that has UHC pays less per person for healthcare than the US, and the majority have better service to show for it. How is this even complicated?

Surely this is simple to understand, under a private system everyone is making money, every layer has its own profit margin, from the insurance agents to the medical groups and the supply companies. This profit adds up very quickly.

No doubt you are going to claim that state run health care is less efficient, so the private is still cheaper which is nonsense. There are of course efficiencies from having a large system, just look at WalMart, its a lot easier to get the drug companies to play fair if you are buying for a nation of 50million in England, than it is for a small hospital group serving a fraction of that number. You also only need one (large) beaurocracy instead of hundreds.

Unless of course you know something about the US that means that a system that works well in every other industrialised nation can't work there.

Mark what you outside of the US types dont understand is that the costs will rise to meet the intake so quickly that it doesnt take an economist to figure it out. Our population is MORE than 50% older people and that will rise to almost 3/4ths in the next 15 years. Depending on who you talk to besides socialists the number is between 8-12 against the 1 who were born of us. There is a term for it here. Hummingbird wings cannot support a well intentioned buffalo's ass. Its a matter of physics.

Our ability to tax to pay for this is going to be nearly impossible as the Social Security system by every, I say again every account is going to account for every dollar taken in starting in three years. You cant tax the Social Security payments or UHC isnt gong to be the only problem we have. Costs will rise to cover the difference that companies and people must make to survive. That means a spiral begins on costs, taxes, costs, taxes. At each turn there is going to be a tax increase and it will reduce this great nation and others to 3rd world status. How could you tax 8-12 people worth of outlay from one child thats born today and expect it to work? It cant and thats pure economics. Even if they taxed the S. Security payments to pay for UHC, it wouldnt be enough. One hospital stay in the US arguably costs 15,000 bucks. Your assertion that bulk buying is the answer is nice but it doesnt work and hasnt except for Wal-Marts pharmacy. Its not reality. You drop your prescription off now and you might get it in three or four hours.

Besides at age 65 they qualify for UHC anyway and its called Medicare. Medicare too is rapidly exceeding the ability to pay its bills and all because we guarantee it without any idea of how to pay for it. To pay for UHC the effective tax rate for middle class America for just the 10 years would have to rise nearly 20%. The idea being that you pay for me, I pay for you. It doesnt work that way. These people would be covered, but by what?

Under the failed to the tune of a near billion dollars TennCare that Bill Clinton said was to be the model for the US, no one paid into the system. There lies the rub, it wasnt mandatory and couldnt be because of the US Constitution. Therefore, those docs that went onto it got hosed because it went bankrupt within four years, they tried to save it with more tax money-700 million and it STILL failed. Even then it still left the state at the 10 year mark with a budget deficit for those years of nearly 1 billion. It accounted for EVERY tax dollar brought in.

But thats history. Here is another part of it. Clinton balanced the budget in 98 by simply not paying the Medicare purveyors. Look up MedShares on the internet. Sent that company completely down the tubes. HealthSouth also almost went under. People ended up being seen in the ER's and talk about lines. 8 hour waits right here in Tennessee. Ended up that there was only one place to be seen within 150 miles for the TennCare/UHC. It was so bad that the national news people started showing up to cover it. Suddenly, the big decision came to drop it.

Canada is different by design, as is the UK, Sweden, France, and on down the road. Socialist countries. None of them spend much on national defense by comparison to the US. If we put this in I can tell you that YOUR taxes are going to go up. You will have to start to defend yourselves even though you are already members of NATO. From whom? That Russian Bear is getting hungry again, we have a world terrorist threat and with all of their oil money the Muslims could topple regime after regime. You are 25 and I can remember that paricular juncture in my life. Jimmy Carter was president and having given away all of the money to the special interest groups (part of it was health care) the economy tanked. Why? High taxes followed by high interest rates. You get the higher interest rates when government starts sucking up all the money. When he started the interest rates were at 8%, by the end of four years of spend, spend, spend it was 21%. That rate was for the good customers. You couldnt get a loan to save your life. Businesses failed, one by one, by one. The dominos started going over.

In the UK you also have to acknowledge a problem in I read 8 years. The same bills are going to come due. They historically try to cut the military budgets and everything else when they overspend in these times and then they hit with a huge tax increase that tanks the economy. You are in the same boat. You cant deny already that healthcare rationing hasnt been underway in the UK. Its posted every day and the head of your national health also said that they might just have to start rationing having spent all the money to improve wait times that the people in the UK put them several billion pounds in the hole.

Its said that our children pay for our mistakes. UHC will take the US out as a world power. Spending more than you make with the general assumption being that you would save money is very presumptious. All of the other economic reasons not to do it were in the previous posts. A cost flare would happen as it did here and then it would go out of control. Rationing would result and then dumping the program.

Thats if its not ruled unconstitutional which it very likely would be.

Randy: I am not outside the US. I am a physician. I see the failure of US health care daily. What you don't understand is that the game is up. We are headed for UHC because that's the only thing that makes any sense. It isn't perfect but it is better than any alternative. As for bankrupting us, you ahve done it with the war in Iraq. Thanks.

Revere if it wasnt Iraq it would be a Kosovo, or a Sudetenland. I do believe in beating swords into plowshares, just not with someone doing it with my head. UHC will never survive in our future. The costs with or without a military would be too great in light of the other lefty steal and spend programs such as Social Security. I hear UHC all the time, but the assertion is that we can pay for it. Cant pay for SS, Medicare, and a military.... Cant have domestic or international security without a military. So besides leaving Iraq how would you pay for it besides RAISING taxes that no one is going to be able to pay anyway? I dont see any income on the older people in about 10 years. Who they going to tax to pay for it as I could never see us in Iraq or Iran in that time?

I keep asking the same question over and over and get no answers. Cant write IOU's anymore. Nor can I see healthcare at all costs. Social Security liabilities alone are in the trillions of dollars. The military you can turn on and off, but not socialist/communist programs. Even the great socialist state went to capitalism after 90 years.

"UHC will take the US out as a world power."

The US is not a world power, a world power does not borrow money from those they fear. With nearly 10 trillion dollars of debt, most of it borrowed from China you really need to wake up and start smelling the coffee. You have a lot of residual power built up during the good times, but you can't continue to spend on the credit card. Your supposed power is already heavily constrained by the fact you can't offend China because they are the ones buying your debt, annoy them too much and they will place their investments elsewhere, you can't do anything about money from Saudi Arabia supporting terrorists because they will cut off you oil, Russia can also play the petropolitics game. So what power do you actually have?

Why the hell do you need to spend so much on the military anyway?, the fact is you have nukes, just as we do, so which enemy nation exactly is going to threaten you? You are currenly spending something like 40% of the total military expediture in the world, does this seem reasonable?

Regarding the costs of an ageing population, that is a problem that will hit regardless of how health care is paid for either by increased insurance premiums or increased taxes. As I have already pointed out UHC costs less per person, so I'll take the better value option when dealing with the increased costs.

Revere:

The need for medical resources expands with the horizons of science. Resources are limited. So the issue will always be: "who gets the resources?".

It's an allocation problem.

We have a similar situation in education. There is a free public system and a parallel (and expensive) private system. The public schools are heavily unionized, and (for various reasons) do not produce the high academic outcomes of the private section.

To me it seems fair that all children should have the same public subsidy. However some parents are more involved. For example, they may prefer a more liberal approach. Should we forbid involved parents from contributing to their own children's education because this is somehow "unfair" to the public school children?

You quoted with approval: "You can't support one system, the private system, without putting down the other system."

Absolute balderdash! Each system covers the failings of the other.

Parallel systems are a metaphor from life. Parallel systems are the driving force of evolution.

bar: The comment in the article about zero sum game here is an empirical question, not a logical one. The speaker is asserting that in his opinion, the way promotion of private insurance is being done is taking down the public system. You have converted it into some kind of Grand Principle, to which I say (with all due respect), Balderdash (but only relative balderdash, not absolute balderdash).

Well the difference about taxation and bond indebtedness is that you can default on bonds Mark. On one hand they could call the bonds, on the other we could revalue our gold and take the world economy into the toilet. Taxes though in this particular instance would go into something you are going to put into the grave in about 30 years give or take for the majority of the people on it. They will for the better part be on Medicare inside of 10 years. Thats UHC and its expensive as shit right now and going to get more expensive. Dont need to tip the apple cart over though by creating a welfare state because that is exactly what it would be. And as a post it to this, if we lose our military and you guys dont beef up your own that leaves only the tactical and strategic nukes....

This was something that George Marshall said in 1956. Lose the conventional forces in lieu of nukes and sure as hell, you'll have to use those instead someday. .

I still don't get your reasoning, if UHC is inherently cheaper (and better to boot) where is the problem? Privatised healthcare is going to get more expensive as well for exactly the same reasons, the only difference is that it inherently costs more per person to start! Your compounding your error by sticking with it.

The only way that privatised healthcare can possibly save money is if you don't cover a lot of people. So all the insurance companies will do is increase premiums, either for everyone, or for the old, leaving more unable to pay.

If I'm reading you right you're suggesting that its better to let people that can't afford healthcare to die, something that will only become more common in the US. This of course probably will include a great number of people that managed just fine during their working lives but can't once they retire and get hit with the rising premiums won't be able to manage, is this fair?

Do you think that is economically a good idea? Allowing those who can't pay to die needlessly? women to die in childbirth, or people to die of simple diseases because they can't afford the insurance. Leaving people that have taken great efforts to nurture and educate to die for want of a doctor? This sounds just like "compassionate conservatism" to me, an example of doublespeak if ever I heard it.

The fact is that there is plenty of money to pay for all the entitlements, as long as you don't have the situation where the richest 10% and the corporations pay next to no tax. Yes its very socialist, people paying to support those less fortunate, but its also about as Christian as you can get, so it amazes me that a supposedly Christian nation can be so blase about the suffering all around them.

You may be able to default on bonds but that would tank your economy, far worse than doing the sensible thing now an sorting out your runaway spending. Besides, who then is going to buy your debt to allow to keep spending like a kid who found his dads wallet? No you can't do anything with that debt but quietly pay it, and that means you do what China tells you.

MRK:

Over here Medicare was introduced circa 1975. The government issued everyone with a "medicare" card, and the government paid about 70% of the AMA scheduled hospital & doctor fees. The cost is met by a 1.5% surcharge on income tax. (See wikipedia
for more explicit details.

The AMA (Australian Medical Association) is the representative doctor's union in Oz, the Doctor's Reform Society mentioned by Revere is a pinko organization that my communist doctor uncle joined back circa the fifties.

The government put an interesting condition when it introduced it's medicare payments. If a doctor was prepared to accept ~70% AMA schedule as full fee, s/he could get paid online instantly. Otherwise s/he could bill the patient, who had to fill in forms to get that 70% refund. Since quite a few patients were recalcitrant on fees, a lot of doctors decided that 70% of the scheduled fee instantly & all the time was better than 100% of maybe nothing.

The net result was more people attending doctors, a general improvement in community health, and doctors working harder for an increased income. Everyone seemed happy, even the taxpayers.

It also meant that the government was able to exert a downwards pressure on doctor's surgery fees.

Nowadays doctors are charging about $50 for a short consult, and the government refunds about $35. That is enough disincentive to stop people from attending spuriously, but not so expensive that even the penurious will not seek medical assistance because of cost. Quite often doctor's will forego the scheduled fee if the patient shows a pension card.

Our medical insurance is essentially for life threatening hospital surgery & postoperative care. For non life threatening surgery, the public health system (UHC) can have a long waiting list. Medical insurance kicks in for non-life threatening surgery. Regrettably some non life threatening diseases (e.g. Gall bladder disease) can lead to debilitating consequences if treatment is delayed. Increased funding could lead to those diseases being moved onto the urgent schedule.

That last paragraph should begin: "Our UHC is essentially utilized for life threatening hospital ..."

Bar-Due respect given to your post. It begins with "The government pays..." In fact that isnt the case now is it? It still takes money from one group of people and then puts it in the hands of others. Be it directly, or thru government services of this type. Under our Constitution the military is specified, the Administrative, Legislative and Judicial Branches and other types of "services" and they are stone hard cold in there. But not this constant redistribution of wealth thing that we have gotten into in the US. You are too rich, you worked too hard, you made too much money... it has to belong to someone else.

With the boomer age group hitting Social Security like a bomb as of a month ago, we are now sucking that trust fund that was stolen from to pay for Vietnam at approximately 10,000 new ones per day. They also hit Medicare. My own mother in law was waiting to have her ass liposuctioned along with her legs when she qualified.

Now we are getting into the money thing. Does this really improve the lives of people? MAYBE....And the maybe is because no one can sit back and simply say okay the economy went because we implemented UHC and we are having to tax the living shit out of EVERYTHING to pay for it. They may be able to get healthcare, but they cant get a job because they have all moved offshore to some country where they cant even spell it.

Besides there are people in the US that need the care and the limits dropped to qualify. I think Melanie has some condition that costs her like there is no tommorow but, because the limits are too high she cant qualify for it. My cousins wife's brother was in a car accident and it took out his spine. He made money right and left until that time. Obviously couldnt get a job afterwards and he had 60 G's in the bank. He applied for Social Security benefits. They told him he could get it after he spent the 60 G's. So he happily bought new computers, a new house, a car etc. to qualify and he is now paid for by the state to be cared for. My brother had polio in the 50's and he is unable to work now due to post polio syndrome. I have to supplement his living now. If UHC is implemented I have warned all my employees that 1/2 or more could be cut due to higher taxes and the insurance that I pay 100% for will be gone with no portability. No employer is going to offer insurance as a benefit if the government is going to take the hit. My people pay the 20 dollar co-pay and I reimburse it now. They can go to just about anyplace in the country and get coverage as its BC/BS. It costs me a fortune to cover them but its the only way to retain good people. I got people fighting to get a job with me....300 applications a month and the vig that gets them heading my way? Insurance of the finest order.

My point is this. We could and should take care of all of those who cant be productive in society. But no way, not a chance, forget it when someone is physically and mentally able to work. My next door neighbor divorced his wife and she was pretty broke. I told her to go and apply at Mickey D's for a management trainee position and her respone, "They dont pay enough." I guess she hasnt gotten hungry enough.

Its a mind set that we are slipping into here. That being that the government will take care of me from the cradle to the grave. With that in mind our lifestyles in lieu of UHC could take a major hit.. Hey, you read about two tiered systems already. Thats a natural progression under the tax and spend. Costs rise to the intake after they figure what they can steal, then they raise the taxes again and again. I counted in the UK since the 1930 . Under our limited government provisions that care HAS to be limited but should take care of those who cant, children and only after they have spent all their money. Why those who have spent the money? This is for the truly indigent, not as a backup position when luck deals you a bad hand. If we didnt, then the abuses would be off the scale and it has been in the past.

The UK started down their path in 1939 and formalized it in 1948 and it put the politicians in charge of public health. Since 1939 the costs have risen, the taxation following it each and every time until the ability to tax has encroached now on the ability to provide jobs. Politicians meddling with your healthcare. Now thats somethingt we REALLY need. Its bad enough now as it is with the insurance companies calling the shots.

I direct you to this particular site and its an unbiased approach to UHC in the UK and its a pretty damning case of inefficiency, costs, and taxation. The bottom line, the healthcare went down for many but extended that same crappy care to everyone with no choice but to pay more to get more. Just like we have to now here in the states. But at least we get to bitch about it here. The idea is that costs would be spread and we would pay less. Indeed not, we the productive and young enough to make money would pay more into the system and the unproductives and elderly would pay likely nothing until the system started to collapse. All of the UHC countries are having to pay more and more as individuals and finally the costs are going to eat their lunch. At that point in time they will dump UHC and go back to minimal coverage for the poor, elderly etc.

http://books.google.com/books?id=Xsfds7xsjqgC&pg=PA1&ots=37LXD0No0d&dq=…

MRK:

I do not know enough about the US system, and suspect you don't know our system.

"It still takes money from one group of people and then puts it in the hands of others.."

Well no. That is exactly what does not happen. Basically, everyone (except pensioners) in Australia pays a flat 1.5% on their income. That is a flat tax on every cent of income. That money is just for UHC. (It is not sufficient for our health care system, but the reason is politics).

That money (and top up from general revenue) is allocated to the UHC and is used to subsidise all doctor's and hospital fees (for everybody) to about 70% of the schedule fee, or 100% in cases of age pensioners etc. The rich get the subsidy, the poor get the subsidy. Admittedly, the rich contribute more, but then they probably use it more (by greater attendances at Drs. Surgery for liposuction etc.)

We don't have the situation where people have to have no assets or income etc to qualify.

If you have a fatal or emergency condition that requires hospitalization (heart attack, broken leg) then you get into a public hospital for free. If you have a non fatal non emergency condition, well if you want hospital treatment within a reasonable time, then you had better have private medical insurance. And if you choose an expensive doctor, & hospital (that charge outrageously over the scheduled fees) then you will have to shell out the difference between the sum of UHC and the private insurance and the medical/hospital fees out of your own pocket.

You will appreciate that the universal application of the scheme means that there is low administrative cost. Patients sign a chit, the doctor bills the UHC computer, and the computer transfers money to the Doctor's account. The UHC has a nifty little statistical analysis program that regularly spots cheats.

What is not so obvious is that medical costs are contained by the fact that the government has set it's refund at about 70% of the scheduled fee. So being sick is expensive, but not (generally) ruinous. And the risk can be considerably reduced by taking out affordable (subsidized) hospital insurance.

Not perfect, but getting there.

Randolph,

Our health system, even with its faults, is still a very good health system.

Everyone in Australia has the right to treatment. EVERYONE.

Bar/Victoria-The problem that lies with this is 1.5% of everyones income. Therefore it is a progressive tax. You make more, you pay more. The US Constitution says that we are all created equal but the US Congress says that you are not....by taxation. There lies the rub. You also have the problems with the massive group who will pay absolutely nothing for this service and thereby raise the taxes on the haves to take care of the have nots. Entitlements is NOT in the Constitution. Its a slow creeping death on the economy of the US. We have goat roped ourselves into becoming a welfare state.

Then there is the statement by Victoria "right to treatment". Healthcare is not a right in the US. It is a service and the rub here is that 40 million cant afford health insurance, but they can get healthcare. Obviously someone is getting it down at the Med because my taxes have gone up some 7 times in 11 years to pay for it. So healthcare is available and they dont have to pay for it now. But I do. They could push this into the courts and if they find that the entitlements programs are all illegal as a push down from this, all Hell is going to break loose.

I can also tell you that this will create an absolutely huge burgeoning bureacracy in the US. We already have too many and that will result in deficits that will grow and grow and grow as we account for money two and three times. They'll use that and produce a report that says, "we need more money." Duh!

Then there is the political aspect of it. I do NOT want some jackass politician deciding what they will and wont cover, what drugs the government is going to negotiate for to buy in mass. Why? Because they NEVER get it right. They are lobbyisted to death now and payoffs, corruption would ensue. Oh sure, everyone will be covered but then we are subjected to the same crappy service that everyone else is, including the indigents. In otherwords, we will still be seeing private care physicians (mostly because they said they wont participate in UHC) and paying straight thru the nose along with the taxes to support a shitty system.

Then its very likely illegal under our Constitution. It would likely require a Constitutional Amendment and that isnt going to happen. In fact this one key issue is starting talk of secession from the US by the S. States. Mandated healthcare.... The South cant afford to pay attention because we have so many people that are uneducated, cant get a job and cant keep one. Adding to that is the immigration problem which is really nothing more than an invasion it will open the flood gates out of Mexico because "Its a right." That alone will bankrupt the system no matter how much money you put into it. States contributions would increase by at least 35% and well shit, thats the same thing we did under TennCare and it totalled the entire state budget within 3 years. All money coming in went out for healthcare. All of it. And what really do we do with the money? We put it into people that if you go cradle to the grave concept it, you put that money into a 6 x 3 hole in approximately 74 years.

You can stand at the graveside and multiply the annual 600 bucks times 74 years of healthcare and say you just put it into a hole. Thats where the money goes...into a hole. It makes people in some cases healthier and able to produce, but it takes the incentive out of the economy and the money out of your pocket, gives it to the government and then at their discretion, they dole it out for healthcare on the whim of an election. It becomes the single consuming issue each and every election. Think not? Look at the UK and how many times its come up since 48....Every year for. Thats crap. I would save us all from this and I aint woofing the Southern states are already telegraphing what they might do. The idea of the United States of CanAmexico is coming to an end and its not going to be pretty what happens.

This isnt freedom... its socialism and a beginning of the takeover by government. The get control of really all your money and when they do they TELL you what you are going to get for it. 70% my butt. Its 70% of your income and then you get to pay a copay that THEY determine what it will be. Of course that copay is waived if you are below a certain income level... Thereby making it a paid for by someone else program in entirety.

"It still takes money from one group of people and then puts it in the hands of others.."

That is the definition of insurance.

The aggregation of risk so that rare but expensive events are paid for by the larger number of payers who dont have those rare and expensive events. But private insurance companies have another cost, that government programs dont have, that is profit. A private company has to make a profit, a government entity doesnt. Those profits are then used to lobby to elect government officials who favor private insurance over public programs.

No Deadie, its called taxation. You have the right not to get insurance. You dont have the right not to pay for someone elses problems under this.

MRK, every emergency room is required to treat every emergency patient that shows up at their doorstep. Who pays for that when the treated patient can't because they didn't have insurance?

MRK. As I explained above, the more you pay for healthcare, the more you are likely to use it (for rich man's complaints like liposuction, more and more comprehensive checkups etc.)

Lets face it big fella. You are paying healthcare for the poor anyhow. I quote:

"Obviously someone is getting it down at the Med because my taxes have gone up some 7 times in 11 years to pay for it. So healthcare is available and they dont have to pay for it now. But I do."

Also consider: As an employer you said you paid private medical insurance for your workers. Have a quick think about what an upfront government UHC payment of 70% of all scheduled medical & hospital fees might do to those premiums...

So if you are going to get screwed (that's not a naughty word in Australia, it sorta translates as "squeezed") you might as well get some benefit out of it. (or is that lie back and..no! no! that's not PC anymore:)

Bar/Deadie.... its a taking under the Constitution. Hence it will be a battle that the leftists will lose.

Deadie-So big fella, we go into the Emergency Room for general care now in Tennessee. Its not the ER anymore, its the GP's office. Why? Because no one takes the socialist medical plan. Burned once is one thing, they aint going to do it again. My doc has already put out the notice that if it comes they will only take private care and in writing. My ortho doc is considering it.

Bar the last 2 para's make sense. The difference is that they go to any doc anytime they damned well please. I am basically paying 100% of their medical now. Its expensive. But its elective too. I wont have to worry about it if they implement it, there wont be any demand for them to be around as it tanks the economy out. It would take a generation to fix this once its implemented and as I said, it will become... the one, the only, the all consuming issue in government because they will fuck it up just like they do everything else. It will become a political issue at every election both state and federal.

Victoria and Bar... Tell me how many news stories a day are on the UHC in Oz? How many are about bad experiences? I have been watching the London Times for almost a year now and EVERY day there is something in it thats bad. Wait times, distance to get to a doctor that MIGHT take you in, in some cases you have to don a birka if you are female. OOOOhhhhh yeah, this is something I want government in charge of.

Screwed is a good description for it. As I said it will be a progressive tax to pay for those who cant, and more so for those who wont and the leftists will ensure it sticks around by pandering to those have nots. Those have nots almost did the economy in the 70's with the gimme programs. This is just another visitation. Everyones lifestyles will drop like a bowling ball out of a plane. Taxes will consume every dollar from Social Security and then, they will want more.

You make valid arguments guys. The only problem is that its not legal in many opinions already written on the subject. They may enact a law to allow it but then have it slapped down ALONG WITH ALL OF THE OTHER ENTITLEMENTS programs and thats when there will be a revolt. Social Security you pay into. The others are just gimme's and if they are found to be unconstitutional, people are going to have to go out and get jobs instead of sitting in welfare homes. The worst thing that could possibly happen to them.

MRK and let me take another bite at that cherry..

In OZ, the people who are exempted from paying UHC are those getting less than about $15k. With unemployment rate around 4%, and massive labour shortages, and a proactive centrelink (social security) pressuring the unemployed to work, you must understand that it might not be so easy to claim a pension worth around $10K. Just about any FT worker gets more than $15K.

Medicare covers about 70% of everything that doctors and hospitals charge for.

The PBS (Pharmaceutical Benefits System) is another organization, run a bit like the US "Federal Reserve", except for pharmaceuticals. A group of doctors are selected (not sure how). They choose just one drug from each generic group, and negotiate a price with the manufacturer. Patients can then purchase that drug on prescription for a maximum (about $30, above that is subsidised) amount. The manufacturer's usually come to the party, figuring I suppose that 30% of their charge for 20 "X" thousand patients is more profitable than 100% of their charge for just 1 "X" thousand patients. So far as I know, the choice of which drug is to be subsidised is not political.

To get Medicare you need a Medicare card. You only get an OZ medicare card if you are a citizen. Since UHC payments are made online, the card cannot be forged. That flood of mexicans using an OZ style Medicare in the USA just wouldn't happen.

Even if Hispanics could access the system, it would not be a disaster. My observation was that Hispanics worked hard for their money. Even with Medicare, health care is not "free". Patients still have to pay that 30% on top. I suspect that only those who really needed health care would go to a doctor.

IMHO the biggest expense in a government bureaucracy is the gathering of information. Things such as checking eligibility. The more universal you make a system, the less the per capita bureaucratic load. Everyone in OZ (even children) get a medicare identity, and a medicare registered doctor can claim online for a treatment for any issued identity. After you are in the system, everything is (mostly) automatic. The only time I need to contact Medicare is when my card wears out.

For those who want the bells and whistles, there is the optional "private healthcare" insurance top-up. The big public hospitals are the best equipped, but massively overworked. The waiting list for non-essential procedures is long. However most hospital theatre operations and care can be performed in the smaller private hospitals at greater cost. Optional private insurance pays most of the difference between UHC and the private hospital & doctor costs.

Randolph, to me it seems that your objections are based on prejudice. You ignore what you don't want to see, and then rail against it.

Summarizing: In OZ, the penurious have the knowledge that they will obtain timely emergency treatment, and that they would (eventually) get non essential treatment. The wealthy can see that their UHC tax dollars are being spent wisely, that they get a disproportionate benefit, and are not just providing enforced charity to the poor.

Bar-I dont rail against what I dont see and I have looked at every UHC just about thats out there and every one of them ends up with long lines (rationing), over-extended financially so its a balancing act on money in the kitty to pay for the work(cant get procedures done), programs that are terminally in money problems and they work at their own pace which is not what the whole concept is about. It is the difference between socialism and communism. The difference between those two is that one day, instead of getting the procedures done it never gets done. You die waiting for it. That is government telling you what to do and what they are not going to do. Mass had implemented a plan that requires you to carry health insurance. You cant work unless you have it. Its a crappy mish-mash of deductibles, whats covered and not and its the exact same thing that Tennessee did. Both will end up in a disaster. Note that its NOT elective. YOU must SUBMIT to government. People who have conditions HAVE to buy insurance. Because of their conditions they have to take high deductibles and therefore its nothing but a gimme to other parts of their society and their original conditions? Not covered in many cases. Thats insane.

http://www.washingtonpost.com/wp-dyn/content/article/2006/04/04/AR20060…

Want to get fined for not having insurance? They have gone to car insurance mentalities up there. You HAVE to have insurance to work, you have to have insurance or we the socialist/communist government will fine you. It costs 1 million a year to care for an in hospital AIDS patient. I personally dont support the lifestyle, I also dont want to subsidize it. So whose rights are being violated here? It takes the hospitals off the hook for the write offs but even this particular money spiral that they just started has IMO less than 5 years before they scream.

This will also raise the overall cost of doing business there. We will indeed see that the jobs start leaving because they cant compete with a non-uhc state or for that matter a country. Its only a matter of time.

As for the 15K Bar.... try 82,000 in New York, 72,000 in Jersey, but only 23,000 in Mississippi, 25,000 in Tennessee to qualify. They will have to first level that playing field...Good Luck on that one. It would happen but then because costs are different in all areas of the US, they would spread say New York costs to Arizona and the costs would rise and rise and rise. This is where they start to go under. The non payers would be so many against the payers it would instantly be in trouble. The will also keep the limits very low to entice the voters. Every one of the UHC's including the vaunted Swedes has, is , or is about to raise the taxes, raise the deductible, or is rationing now. Why jump off the precipice?

This country cannot afford this and it will lead to those headlines that I read from Germany, UK, France, Oz, Canada of medical disasters..."died while waiting", "six months for hip replacements", "Two years waiting for knee replacement". Thats not healthcare, its a government run bureacracy and to blazes with yet another failed program. Dominion by government over your physical body and that government TELLS you what you are going to do.

Hell in Canada they are making documentaries on it how many people have died, not worked in years, and how screwed up it is. Socialism in a Capitalistic society will not work and hasnt each time we have tried it. The Great Society didnt. LBJ sat on the porch of a poor white sharecropper in 1964 not 30 miles from my house and told him that we are the government and we are here to help. 1994 the man was interview by the local newspaper and was asked if anything had changed. "Yup", he said. "The roof caved in twice since then".

Here is the problem. There are those that INSIST that we have to do something about healthcare. There are those that also INSIST that this is my problem, I have to stop what I am doing and pander to those people? They have problems, I have problems and healthcare for them isnt on my list of things I want to pay for today...I have the right to say no. I pay for my healthcare and that of others as a benefit. They now want me to extend my benefits to people to whom I have no relationship. They would make it the law to take from someone and give it to someone else. They do it because they think its something thats necessary and it takes away the rights of one group to give them to another and thereby it is a taking under the constitution and therefore is illegal. We are all afforded the right to life liberty and pursuit of happiness, not that it will be extended to you. The fuzzy math of UHC never is known until they implement it then the real costs come into play. The UK experienced some upheaval every year since implementation. Not enough docs, not enough nurses, health warehouses is what the hospitals become.

Then there is the availability of care.Everyone would flock to the docs and flood the system because "its free". Then instantly the costs rise to meet demand. Thats basic economics.Jobs would be lost and even though they have healthcare they still have to eat and have a roof over their heads. No, its just another cash flow scheme of government.

You know, we could just sit and do NOTHING and as the boomers age in 12 years they will already be eligible for our other socialized and very screwed up system...Medicare. Children? Every state covers children now. The lefties want that extended to massive levels that ensures the demise of the US.

http://ezraklein.typepad.com/blog/2007/01/individual_mand.html

MRK:

I will try to correct what I think are your misunderstandings.

"every one of them ends up with long lines (rationing), over-extended financially so its a balancing act on money in the kitty to pay for the work"

The long lines in OZ are not due to lack of federal UHC money, but to our underfunded public hospitals. (Matter of fact, you can frequently travel from one region to another where the waiting list on a particular operation is shorter.) That underfunding is because our socialist state governments have better places to spend the money (like overseas trips to Las Vegas to see how you guys deal with the gambling problem) than public hospitals in conservative electorates.

There is no free UHC medical in OZ, except accidents and stuff like heart attacks. If you needed a hip joint and it was going to cost $10,000, well under UHC you can get it tomorrow. It only costs about $3,000, because they refund about 70%. That reduction is hardly going to cause:

"Everyone would flock to the docs and flood the system because "its free". Then instantly the costs rise to meet demand. Thats basic economics."

If you wanted it free then you could get it in a public hospital, but you would have to wait. That is not because of UHC. It is because the state governments, which manage hospitals, run those hospitals at a loss.

To combat that "basic economics" law, We allow temporaries (overseas medical personnel) to fill the gap. Medical degrees from India or Bangla Desh help to provide the excess labour when demand outstrips supply. (It also gives us a warm feeling, because those transfer payments are helping the economy of Bangla Desh.) The government is rectifying the pressure somewhat by subsidizing nursing training, but has yet to act to increase the number of medical graduates.

You tell me about the different styles of UHC by the various states. You tell me that the UK and Canada went wrong because they don't give full coverage to all medical conditions, but apparently they give full coverage to the cost of those conditions. I don't know about those places. OZ UHC provides coverage of most of the cost for all medical (but not stuff like homeopathy) treatments. You find the service, then UHC pays 70% of the cost.

You also raise the issue that you don't like being forced to look out for your neighbour. Your own interests are served by compulsory payments for police, roads, water reticulation and other such services that require group cooperation and are a benefit to all. Many things in health can be rationalized on the same basis. That AIDS person who costs $100,000 pa in hospital (if they are in hospital, aren't they usually terminal within weeks) only costs $10,000 pa or so medicines to remain a productive member of society for years. Probably pays more than $10k pa in taxes. It is arguable that the investment by society to provide a basic level of public assistance via UHC is profitable, even if it is only to prevent the spread of infectious disease. And if you find some unidentifiable hit & run victim, isn't it best to have a scheme that pays for EMED?

That $15,000 I mentioned only relates to whether or not the OZ citizen is liable for payment of the 1.5% UHC tax. Earn less, no tax. Earn more, pay tax. But the UHC benefit is available to everyone, regardless of income. Even our billionaires get that same UHC benefit that a beggar would obtain.

Well Linzel I'll forgo my usual cites lists for the sake of brevity. The Canadian health system is starting to come apart too. An aging population cannot pay what they make on the social system, back into the system without there being an economic collapse there or here.You are indeed like the US in that you have deadbeats... Wait till the Mexicans show up on your border-they have bankrupted our county budget already and our public health facility is about to close. Their answer? Raise taxes.

Once they feed on us they will be up there. They dont even have to swim it in the summertime to cross the border. We have a problem in the US that if they implement something like this the doctors will bail out too. They cant make it on what they charge now and pay their malpractice insurance. I quizzed every doctor I know that I have seen in the last year and they all say it will be a disaster. The older doctors said they will just retire. Dentists (3) told me no way. One heart specialist, one neuro, one spine and my favorite female family GP.

They said they'll be private and stay that way because instead of dealing with some adminstrative person in an insurance company, they'll be dealing with an administrative person in government. Not worth it and plenty of people out there that will shuck out of the system.

Costs would initially drop for John Q. Public and then it will rise incrementally until the GOVERNMENT gets all the available spending money in your pocket. No job growth with that. The poor will increase their share and two-tier and rationing will result. Their kids will be having to pick up the tab for Social Security, UHC and general taxes. Can someone explain to me how in hell they plan to pay for it? Tax the rich? There arent enough of them to do it and its based on progressive income taxes. They simply will move everything offshore. Tax the corporations? Yeah if you want to shut down the economy. You think they are going to allow their costs to go off the scale? They'll move what manufacturing there is to Honduras. Tax the middle class? Yep, and it will shrink because the poverty line will rise and rise and rise.

Wonder why they are trying to dump it in Oz? Probably because like us its now moving into the older people and they are costing more and more to support from a health care standpoint. In Canada there was a MP that was trying to prosecute people for seeking outside healthcare. Its a takeover, socialism and likely very illegal under our Constitution. Nothing in it says that life, liberty and pursuit of happiness will be provided for you. NOR does it say that word ENTITLEMENTS in it. This could become a constitutional showdown issue in the courts and if they lose, not only will they lose this one but it ensures that the tax issue in general comes to a head....finally. The idea being that we (some of us) are too successful and that we should work to support those that dont, wont, and in I read about 3% of the population ...cant. I have no problem with the latter. Those who CANT get insurance then their particular states must provide it for them at a reasonable cost. Reasonable is dictated by the government of course.

Remember I am in the Poor South. I have family (cousins) who make more on welfare than they do going to work. I also have family that are VP's in the largest corps. in the South. So someone tell me or show me where it says in the US under its laws that we owe anyone else a living. They take it from the rich (rich by whatever ambiguous standard there is that month) and give it to the poor.

Clintons definition just as he left was that a single mom, with three kids making 50 K a year is rich! Uh-huh. I rank that right along with UHC and the dumbasses that they will balloon into the size of government to deal with it. Can you imagine how many people it will take just to manage it? Someone is going to have to pay for it and it wont be 40 million Americans. It will be 175 million Americans that will drop to 125 million Americans in 10 years then 73 million in 15 then like 55 million in 20. Thats the peak of the baby boom. EVERYONE will be on the dole. S.Security, UHC, Medicare, Aid to Dependent Children etc. That 40 million will grow up to basically only understand welfare and not jobs and the standard of living in this country will drop like a rock. It will also tank the stock market. No free spendable income means no investments. They will be taxing the shit out of everything.

Education... down the toilet. No money for it. Its all going to go to healthcare. Revere is right but for a different reason about the US being a 3rd rate nation in 15 years. It will be because we have become a socialist state in a capitalistic society. I think the last time that happened was when Jimmy "Gimme" Carter was President. Couldnt fight a war because there wasnt anyone to fight it. Nor were there parts for aircraft and aircraft carriers sat in dry dock for months waiting for the money and, bloompf there goes Afghanistan, and Iran. What does Canada do when the Russians are coming?

Yeah, UHC...thats the ticket. It will bankrupt us in under 10 years for sure and they'll raise the taxes, then the interest rate as the government becomes progressively more insolvent, jobs will go and there goes the game.

History repeats itself. Print this off and save it for the future. See if it doesnt come true if it happens. With all due respect to the Canucks, they'll have to start building up their military. We wont be there this time around. Too expensive.

Jason.... Biting the bullet might really mean that this time around.