Holland - An Alternative Health Care System

[Toro]

I find this debate on whether or not health care is better in Canada or the US to be stale - as if there are no other alternatives.

Well, here is one country that is a mixture of both. I am no expert on healthcare financing, but I feel the solution, or quasi-solution, between the problems in health care for Canada and America lies somewhere in between the two systems.

The Netherlands.

The Netherlands is using competition and a small dose of regulation to pursue what many in the U.S. hunger to achieve: health insurance for everyone, coupled with a tighter lid on costs.

Since a new system took effect here last year, cost growth is projected to fall this year to about 3% after inflation from 4.5% in 2006. Waiting lists are shrinking, and private health insurers are coming up with innovative ways to care for the sick.

The Dutch system features two key rules: All adults must buy insurance, and all insurers must offer a policy to anyone who applies, no matter how old or how sick. Those who can't afford to pay the premiums get help from the state, financed by taxes on the well-off.

The system hinges on competition among insurers. They are expected to cut premiums, persuade consumers to live healthier lives, and push hospitals to provide better and lower-cost care.

Some are already taking unusual steps. The insurance company Menzis has opened three of its own primary-care centers to serve the patients it insures, and plans to open dozens more in a move to lower costs. Rival UVIT offers discount vouchers to customers who buy low-cholesterol versions of yogurt, butter and milk.

To prevent insurers from seeking only young, healthy customers, the government compensates insurers for taking on higher-risk patients. Insurers get a "risk-equalization" payment for covering the elderly and those with certain conditions such as diabetes. ...

What works in the Netherlands, a small country of 16.6 million people, may not readily apply to America. A Dutch-style scheme would likely raise opposition among U.S. doctors and Republicans who are cautious about higher taxes. But many U.S. states are similar in size, and one, Massachusetts, is already experimenting with a universal-coverage scheme.

"The lesson for America is that this is what we ought to do," says Alain Enthoven, a professor at Stanford University.

Three decades ago, Prof. Enthoven published a pioneering proposal for what he called "managed competition," a version of which the Dutch have now adopted.

The Enthoven plan partly inspired the Clinton administration's failed health-care overhaul effort in the 1990s. It has now come full circle. Last October, an economist from the Dutch health ministry was invited to describe his country's new approach to about 50 Massachusetts politicians and policy makers in Boston, as the state was developing its own plan for mandatory health insurance. ...

The notion of competition among insurers is nothing new to Americans. Most Americans under 65 get insurance via their employer, which can compare plans and pick the one that it thinks offers the best coverage for the money. To cut costs, U.S. insurers bargain with doctors for discounted rates and try to weed out overbilling and frivolous treatments.

The system has failed to stop U.S. health costs from shooting up, and it has left many doctors complaining that their medical judgment is being second-guessed by bean counters. It isn't clear that a Dutch-style system, also centered on insurer competition, could do any better. Dutch doctors were among the most vociferous opponents of an overhaul and many remain skeptical.

Still, there are some differences in the Dutch way that may work to its advantage. One is the emphasis on individuals buying coverage. In the U.S., employers tend to be poor buyers of health care. They're unfamiliar with the needs of the people actually using the health care -- their employees -- and it is difficult for a large company to switch insurers.

By putting the onus on consumers, Dutch officials hope that more people will get the coverage they need. The "risk equalization" that helps Dutch insurers cover sicker people is also critical. In the U.S., competition among insurers often means competition to find the healthiest customers, especially in the individual market. ...

n late 2004, the Dutch House of Representatives passed a law to usher in mandatory health insurance and switch people on state-run insurance to private carriers. But family doctors fretted that it would allow insurers to interfere in medical decisions, for example by pushing cheaper drugs.

The following May, thousands of Dutch general practitioners went on a three-day strike. Some tied their hands together with rope to symbolize their helplessness. In response, Mr. Hoogervorst promised to provide some protections for doctors in the new legislation. One of them was that patients wouldn't bear a big financial cost if they chose to go to a doctor not under contract with their insurer. Soon after, the senate approved the new plan.

It took effect on Jan. 1, 2006. Despite predictions of chaos, the changeover was surprisingly smooth. The government set up a Web site where consumers could analyze insurers' offerings. Consumers were allowed to switch insurers once a year. As 2006 approached, the health ministry predicted that only 5% would bother. Instead, nearly 20% of people switched, either to get a better price or because they were dissatisfied with their insurer. ...

In most European countries, consumers have no idea what their health insurance costs because they are covered by national health-insurance schemes financed by payroll taxes, as used to be the case in the Netherlands. On a visit to Germany last year, Mr. Hoogervorst boasted that thanks to his country's switch to private insurance paid by individuals, "no other European country has a population so keenly aware of the costs of their health-care insurance."

Now that they see the bills more clearly, some consumers feel their payments have gone up. In one survey mainly of labor-union members, about 70% said they were financially worse off in some ways. ...

The real test of the Dutch approach is yet to come: Can insurers push hospitals to lower their costs and improve their quality? Insurers have clout because they can direct large numbers of patients toward particular hospitals. But, in a holdover from the old system, insurers can currently negotiate prices for only 10% of the services hospitals offer. The figure will rise to 20% by the end of this year, and continue to go up.

Because Dutch hospitals used to receive fixed prices for their services, and got more money for more service regardless of quality, they had little incentive to improve their care. Under the new system, insurers should be providing that incentive, but Mr. Hoogervorst acknowledges, "There's still a long way to go to increase competition among hospitals." ...

WSJ

 

[Angel Heart]

Most of America does have both. In Oregon there's the Oregon Health Plan. It covers all children and adults that are low income and don't have it available through work. They even have a program for those that can't afford the out of pay cost of employee covered ins. The thing too many forget is that the US isn't one large blob. We have states. Each state runs as if the state is it's own country. The Federal government is there for interstate commerce and to defend the whole. The health care issue needs to be addressed at the state level not the federal.

 

[ScreamingEagle]

I find this debate on whether or not health care is better in Canada or the US to be stale - as if there are no other alternatives.

Well, here is one country that is a mixture of both. I am no expert on healthcare financing, but I feel the solution, or quasi-solution, between the problems in health care for Canada and America lies somewhere in between the two systems.

The Netherlands.



WSJ

What's so great about this system? You still have the insurance companies controlling your heath services. You, the individual, are still just left as a pawn in the insurance game. Your doctor also gets to have his hands tied too.

The system hinges on competition among insurers. They are expected to cut premiums, persuade consumers to live healthier lives, and push hospitals to provide better and lower-cost care.

I'd like a system where the individual is the one who is in power and control of his own health services---
not the insurance company,
not an employer,
not the government.

 

[mattskramer]

I'd like a system where the individual is the one who is in power and control of his own health services---
not the insurance company,
not an employer,
not the government.

That used to exist in America a few decades ago. There was no Medicare or Medicaid and many people did not buy health insurance. I don’t know of such a system today where someone is not required to have coverage (through government or a private firm). I don’t know if you can opt out of Medicare or Medicaid. If you can, then I suppose that you would be responsible for your own health. You better be responsible and save your money wisely if you want to be solely responsible for your health care coverage.

 

[Bern80]

Interesting. My opinions on the subject are fairly well known. I wouldn't be oppossed to the tax increase a system like that would require if we could fugure out other ways to reduce taxes. There are most certainly some superfluous things in our tax code that could be done away with.

 

[Toro]

What's so great about this system? You still have the insurance companies controlling your heath services. You, the individual, are still just left as a pawn in the insurance game. Your doctor also gets to have his hands tied too.

The problem with government is that it often does not respond to supply and demand in an efficient manner.

The problem with a free market is that some will not be able to afford the product at the clearing price. That's okay if we're talking about a car or a vacation, but health care is different because it involves the security of lives, similar to the armed forces and the police.

The idea is to create a system where the market is allowed to clear as many as possible, and the government covers those the market leaves behind. In fact, this describes all health care systems in the industrialized world, the only difference is degree of involvement by the government and the market.

This system in Holland has only just started, so it remains to be seen whether or not it will be successful. However, I like the idea of insurance companies not being able to refuse coverage. My wife met a guy at the dog park a few weekends ago who had a heart attack and now cannot get insurance. He's in his late 40s, slim and otherwise healthy. That, to me, is abominable.

 

[ScreamingEagle]

The problem with government is that it often does not respond to supply and demand in an efficient manner.

You got that right. There is no way I want to sit in some dirty waiting room for hours when I am sick. If the clinic must be profitable it will be customer-oriented...not like some DMV where government workers don't give a damn if you have to wait all day.

The problem with a free market is that some will not be able to afford the product at the clearing price. That's okay if we're talking about a car or a vacation, but health care is different because it involves the security of lives, similar to the armed forces and the police.

Health care involves the "security of lives"? Is that the new liberal justification for socialized medicine? Hey, when liberals stop supporting abortion then maybe I'll believe they are really concerned about the "security of lives".

Let me tell you...there is NOBODY as concerned about your health and your security as YOU. The government will NEVER be as concerned about your health as you are. When you are the customer you are calling the shots and YOU are in control.

The idea is to create a system where the market is allowed to clear as many as possible, and the government covers those the market leaves behind. In fact, this describes all health care systems in the industrialized world, the only difference is degree of involvement by the government and the market.

You mean the government will pay for the poor, as per usual. I have no problem with the government paying for a core group of the destitute but that is not a good reason to change the whole system over to socialized medicine.

This system in Holland has only just started, so it remains to be seen whether or not it will be successful. However, I like the idea of insurance companies not being able to refuse coverage. My wife met a guy at the dog park a few weekends ago who had a heart attack and now cannot get insurance. He's in his late 40s, slim and otherwise healthy. That, to me, is abominable.

The Holland system started out with patients waiting in lines. I like the idea of not going to any system that has that problem for starters.

Many states here make it illegal to refuse coverage. What happens then is the person is able to buy coverage but he then has to pay a small fortune for it or they exclude prior problems. The real problem is why a healthy guy in his late 40s was running around without health insurance to begin with. Maybe he was between jobs? That's how a lot of people wind up stranded without insurance. This is why a person's health insurance should NOT be dependant on having a job. A person should be able to go out and buy the health insurance coverage of his choice like he buys car insurance. The coverage would remain in effect for as long as he paid his premiums. Health premiums would remain fairly low if the coverage did not include everything on top of catastrophic coverage. Regular visits to the doctor, lab tests, etc. should be paid for at the time of the visit. This would keep insurance companies out of the picture to a large degree. This is what HSAs (Health Savings Accounts) would be used for. A person could have quite a little bundle of cash set aside for his health needs by the time he was in his 40s.

I might be agreeable with a law that required everybody to buy at least catastrophic health insurance....kind of like how we are required to buy at least minimal auto insurance. This would keep the insurance pool bigger and premiums down.

 

[Toro]

You got that right. There is no way I want to sit in some dirty waiting room for hours when I am sick. If the clinic must be profitable it will be customer-oriented...not like some DMV where government workers don't give a damn if you have to wait all day.

Me neither.

And the hospitals in Canada are as clean as the ones in America, or at least the ones I've been in.

Health care involves the "security of lives"? Is that the new liberal justification for socialized medicine? Hey, when liberals stop supporting abortion then maybe I'll believe they are really concerned about the "security of lives".

I'm very much against abortion.

Why have a socialized police and a socialized army, then? We all know that the private systems works better than the government. Private police and private armies exist today in some parts of the world. Why not in America?

What does it matter if you die of cancer or a terrorist bomb? Dead is dead is dead. And you are several thousand times more likely to die from cancer than terrorism.

Let me tell you...there is NOBODY as concerned about your health and your security as YOU. The government will NEVER be as concerned about your health as you are. When you are the customer you are calling the shots and YOU are in control.

And nobody is more concerned about your security than you. Yet, people are willing to have the government provide society with policing and armed forces and firetrucks and all sorts of other services.

Understand I'm not against private insurance. However, I find it a contradiction that many people who believe strongly in increasing spending (and thus taxes) on the military and the police are strongly opposed to government involvement in health care.

You mean the government will pay for the poor, as per usual. I have no problem with the government paying for a core group of the destitute but that is not a good reason to change the whole system over to socialized medicine.

What I put forth was not to turn a whole system over to socialized medicine. What the system in Holland does is include a blend of government and private insurance.

Many states here make it illegal to refuse coverage. What happens then is the person is able to buy coverage but he then has to pay a small fortune for it or they exclude prior problems. The real problem is why a healthy guy in his late 40s was running around without health insurance to begin with. Maybe he was between jobs? That's how a lot of people wind up stranded without insurance. This is why a person's health insurance should NOT be dependant on having a job. A person should be able to go out and buy the health insurance coverage of his choice like he buys car insurance. The coverage would remain in effect for as long as he paid his premiums. Health premiums would remain fairly low if the coverage did not include everything on top of catastrophic coverage. Regular visits to the doctor, lab tests, etc. should be paid for at the time of the visit. This would keep insurance companies out of the picture to a large degree. This is what HSAs (Health Savings Accounts) would be used for. A person could have quite a little bundle of cash set aside for his health needs by the time he was in his 40s.

I might be agreeable with a law that required everybody to buy at least catastrophic health insurance....kind of like how we are required to buy at least minimal auto insurance. This would keep the insurance pool bigger and premiums down.

I think there are some good ideas in there.

Per my example, the guy I mentioned who had a heart attack had insurance, was dropped and cannot get it now.

 

[ScreamingEagle]

Why have a socialized police and a socialized army, then? We all know that the private systems works better than the government. Private police and private armies exist today in some parts of the world. Why not in America?

Because we do not want a private force gaining physical control…we'd quickly wind up under a dictator.

What does it matter if you die of cancer or a terrorist bomb? Dead is dead is dead. And you are several thousand times more likely to die from cancer than terrorism.

The primary function of government is to protect the country from attack, not to care for the sick.

And nobody is more concerned about your security than you. Yet, people are willing to have the government provide society with policing and armed forces and firetrucks and all sorts of other services.

True. Yet, if the country is attacked, the government, which is in a much better position to maintain a big army, can respond immediately to the threat for everybody concerned. However, if your body is attacked by an illness, only you, the individual, need to get help, so you go to your private doctor who knows your specific health needs.

Understand I'm not against private insurance. However, I find it a contradiction that many people who believe strongly in increasing spending (and thus taxes) on the military and the police are strongly opposed to government involvement in health care.

Why a contradiction? Maybe you see the government as some sort of parental figure that is supposed to take care of all your big needs. I believe our federal government should exist primarily for our country's defense. I see individual health concerns as private business and primarily between you and your doctor.

What I put forth was not to turn a whole system over to socialized medicine. What the system in Holland does is include a blend of government and private insurance.

Why have the extra layer of government on top of the private insurance for everybody? Why not leave along those people who can pay and let them shop for their own personal health care services in a competitive market? Let the government supply its own health care program for those indigents who may fall through the cracks. That would make it smaller and easier for the government to manage.

I think there are some good ideas in there.

Per my example, the guy I mentioned who had a heart attack had insurance, was dropped and cannot get it now.

Thanks. Do you have any idea why he no longer had insurance at the time of his heart attack?

 

[Ruby]

Because we do not want a private force gaining physical control…we'd quickly wind up under a dictator.

Why then trust them with our health care?

The primary function of government is to protect the country from attack, not to care for the sick.

Says you but it isnt true at all. Govt has numerous functions and it boils down to the function of helping the community run itself. It includes crime control, education, transportation, economy, health etc. A community of human beings concern themselves with numerous issues and we have govt as a central location to determine them, implement them and enforce them.

True. Yet, if the country is attacked, the government, which is in a much better position to maintain a big army, can respond immediately to the threat for everybody concerned. However, if your body is attacked by an illness, only you, the individual, need to get help, so you go to your private doctor who knows your specific health needs.

The same can be said of the health of the nation. The best way to cater to the entire communities health needs is to create system that is available to all.

Why a contradiction? Maybe you see the government as some sort of parental figure that is supposed to take care of all your big needs. I believe our federal government should exist primarily for our country's defense. I see individual health concerns as private business and primarily between you and your doctor.

Its not about "parental" is it? "Government" is a vehicle for a community to deal with issues that are natural and inherent to communities and how to best handle them for the benefit of the community.

Why have the extra layer of government on top of the private insurance for everybody? Why not leave along those people who can pay and let them shop for their own personal health care services in a competitive market? Let the government supply its own health care program for those indigents who may fall through the cracks. That would make it smaller and easier for the government to manage.

Not really, it encourages us to provide sub-standard care for the weakest and most vulnerable section of our society. We already seem to view poverty as a moral and character flaw...the poor are always the least heard and the least cared about.

We also invite yet another problem....what to do when insurance companies place unfair practices into play and leave people under-insured, they wont qualify for "govt funded" care and yet the insurance they pay for leaves them without adequate coverage. We have seen more and more companies refusing justified claims, drop policy holders or turn people down due to pre-existing conditions.....we have a large portion of people falling through cracks that we are creating.

 

[ScreamingEagle]

Why then trust them with our health care?

A private clinic is not the same as a private army. Are you against private shopping malls too?

Says you but it isnt true at all. Govt has numerous functions and it boils down to the function of helping the community run itself. It includes crime control, education, transportation, economy, health etc. A community of human beings concern themselves with numerous issues and we have govt as a central location to determine them, implement them and enforce them.

So you think health care is more important to government than the defense of our country?

The same can be said of the health of the nation. The best way to cater to the entire communities health needs is to create system that is available to all.

Individuals have many different needs. What makes you think the government would be able to cater to all of them? And do it cost effectively? It has a hard enough time handling just the one basic need of our country - that of defense. You libs squack all the time about how much that costs.

Its not about "parental" is it? "Government" is a vehicle for a community to deal with issues that are natural and inherent to communities and how to best handle them for the benefit of the community.

I'd say it is for many people, as they think of the government as some sort of parent or Big Brother. Many are quite willing to give up their responsibilities of freedom for the comforting promise of being taken care of.

Not really, it encourages us to provide sub-standard care for the weakest and most vulnerable section of our society. We already seem to view poverty as a moral and character flaw...the poor are always the least heard and the least cared about.

Well, if the government can only provide substandard health care for a core group of the weakest among us, what makes you think it is going to provide better care for the rest of us?

We also invite yet another problem....what to do when insurance companies place unfair practices into play and leave people under-insured, they wont qualify for "govt funded" care and yet the insurance they pay for leaves them without adequate coverage. We have seen more and more companies refusing justified claims, drop policy holders or turn people down due to pre-existing conditions.....we have a large portion of people falling through cracks that we are creating.

I've advocated HSAs and individuals paying directly for their ongoing health care needs which would go a long way towards bring down health care costs and getting rid of insurance companies controlling your health care. For catastrophic needs, which are too costly for the average person to handle, there would be a place for health insurance to cover major costs. This catastrophic health insurance could be mandatory for people to have, just like auto insurance. However, routine health care bills can be treated just like any other bills people have to pay without running them through (and being nitpicked by) some insurance company (or the government, for that matter). The individual would have direct responsibility for and control of these bills with his doctor and clinic. No claim forms needed.

 

[Ruby]

A private clinic is not the same as a private army. Are you against private shopping malls too?

Health care is certainly well beyond a "mall". Its not a luxury, its a necessity.

So you think health care is more important to government than the defense of our country?

Trying to play the issues against one another is a bit silly. They are both important but health care is DEFINITELY as important and plays a role in everyones daily lives.

Individuals have many different needs. What makes you think the government would be able to cater to all of them? And do it cost effectively? It has a hard enough time handling just the one basic need of our country - that of defense. You libs squack all the time about how much that costs.

Many nations do it effectively... pretending that health care isnt right up there with national defense, education, police, fire depts, public utilities etc dosent make much sense.

Also lets please try to remember it would be health care FUNDED by the govt via US tax dollars and not RUN by the govt. It would be RUN by health care professionals and health administrators.

I'd say it is for many people, as they think of the government as some sort of parent or Big Brother. Many are quite willing to give up their responsibilities of freedom for the comforting promise of being taken care of.

It has nothing to do with "freedom" for a community to provide health care for itself AS a community. It has to do with making human health a priority. All human beings utilize it at some point in their life and most will utilize many times in their lives. It makes sense to fund it on a nationwide level since all in the nation will actually need it.

Well, if the government can only provide substandard health care for a core group of the weakest among us, what makes you think it is going to provide better care for the rest of us?

Creating a 2 tiered system that is based on income means that the ones for poorer folks will be made sub-standard on purpose. Its the way we seem to treat the weakest in the US. If we create a system that we ALL use, then we see some higher standards applied and implemented.

I've advocated HSAs and individuals paying directly for their ongoing health care needs which would go a long way towards bring down health care costs and getting rid of insurance companies controlling your health care. For catastrophic needs, which are too costly for the average person to handle, there would be a place for health insurance to cover major costs. This catastrophic health insurance could be mandatory for people to have, just like auto insurance. However, routine health care bills can be treated just like any other bills people have to pay without running them through (and being nitpicked by) some insurance company (or the government, for that matter). The individual would have direct responsibility for and control of these bills with his doctor and clinic. No claim forms needed.

The problem is that many people still wont be able to afford the catastrophic insurance you want to require....shall we imprison those people? Ongoing costs are very high NOW, people cant afford it. Just recently a friend of mine in the US who has no insurance had to pay over $100 for the doctors office visit and $85 for the prescription. If she has needed any lab tests she would be out even more money...she also has 2 kids. What if they all 3 came down with strep throat? We would be looking at a pretty big bill. That isnt going to keep costs down.

The problem we have are inflated costs everywhere and we need cost controls that are GOVERNMENT enforced, which is one of the first things any socialized system has to do. That means the pharm companies dont get to keep raking everyone over the coals. It means the hosptials actually get paid for their services and dont have to pay people just to fight with the insurance companies trying to get their money or sending stuff to collection agencies trying to get people who cant afford it to pay.

A mix of socialization and privatization is absolutely possible and certainly the model many socialized health systems are following. They very key important element is that ALL are entitled to it and have access to it equally. Your income or employment should have NOTHING to do with it.

Editing to add one more important point. The US currently spends MORE per capita than the other developed nations do in their socialized systems. This means the US is doing it wrong and I would trace that problem to the fact that govt is more beholden to large business interests than it is to the american people. Demanding a universal system with price controls on what the US tax payers pays for things would go a long way to fixing that issue. The US is quite capable of creating a good system, its just our job to root out some of the corruption that is determined to line pockets with US tax payer money instead of using that money for the actual US citizenry.

 

[ScreamingEagle]

Health care is certainly well beyond a "mall". Its not a luxury, its a necessity.

Well then, what about grocery stores? Isn't food a necessity? I wouldn't call it a luxury. You can shop for food at a shopping mall.

Trying to play the issues against one another is a bit silly. They are both important but health care is DEFINITELY as important and plays a role in everyones daily lives.

I'd say eating every day is even more important than health care. Should we then have a socialized food program?

Many nations do it effectively... pretending that health care isnt right up there with national defense, education, police, fire depts, public utilities etc dosent make much sense.

I'd say no nation has much better health care than the U.S. There are some problems, I'll agree, but why screw it up even more by getting the government involved? Name one big government program replacing a private one that has succeeded and been more cost effective.

Also lets please try to remember it would be health care FUNDED by the govt via US tax dollars and not RUN by the govt. It would be RUN by health care professionals and health administrators.

He who controls the money controls. I want to see the consumer in control, not the government.

It has nothing to do with "freedom" for a community to provide health care for itself AS a community. It has to do with making human health a priority. All human beings utilize it at some point in their life and most will utilize many times in their lives. It makes sense to fund it on a nationwide level since all in the nation will actually need it.

Yes it has everything to do with freedom. Talk to any doctor who wants to set up a clinic of his own. It's called a business in a free market. Talk to any health customer who wants the freedom to choose where he spends his dollars for the health care of his choice.

Creating a 2 tiered system that is based on income means that the ones for poorer folks will be made sub-standard on purpose. Its the way we seem to treat the weakest in the US. If we create a system that we ALL use, then we see some higher standards applied and implemented.

Why would a government program for the poor be sub-standard? Can't the government get it together? I have absolutely no reason to believe a government health system would be any better than a private one.

The problem is that many people still wont be able to afford the catastrophic insurance you want to require....shall we imprison those people? Ongoing costs are very high NOW, people cant afford it. Just recently a friend of mine in the US who has no insurance had to pay over $100 for the doctors office visit and $85 for the prescription. If she has needed any lab tests she would be out even more money...she also has 2 kids. What if they all 3 came down with strep throat? We would be looking at a pretty big bill. That isnt going to keep costs down.

The problem is many people are irresponsible. Liberals seem to encourage that with their socialistic promises. Maybe there should be penalties for those who refuse to get catastrophic insurance. You get fined if you don't carry auto insurance.

The problem we have are inflated costs everywhere and we need cost controls that are GOVERNMENT enforced, which is one of the first things any socialized system has to do. That means the pharm companies dont get to keep raking everyone over the coals. It means the hosptials actually get paid for their services and dont have to pay people just to fight with the insurance companies trying to get their money or sending stuff to collection agencies trying to get people who cant afford it to pay.

How can their be "cost controls" when big business and government are mixed together?

A mix of socialization and privatization is absolutely possible and certainly the model many socialized health systems are following. They very key important element is that ALL are entitled to it and have access to it equally. Your income or employment should have NOTHING to do with it.
What do you mean your income has "NOTHING" to do with socialized

What do you mean your income has "NOTHING" to do with socialized medicine? Where do you think the money to run it would come from? Don't you realize that another big chunk will be taken out of your paycheck?

Editing to add one more important point. The US currently spends MORE per capita than the other developed nations do in their socialized systems. This means the US is doing it wrong and I would trace that problem to the fact that govt is more beholden to large business interests than it is to the american people. Demanding a universal system with price controls on what the US tax payers pays for things would go a long way to fixing that issue. The US is quite capable of creating a good system, its just our job to root out some of the corruption that is determined to line pockets with US tax payer money instead of using that money for the actual US citizenry.

I agree that big business (such as Big Pharma) are in bed with the government and that is increasing our costs. We need a shake out for sure but I don't see how creating another government boondoggle is the answer.

 

[Ruby]

Well then, what about grocery stores? Isn't food a necessity? I wouldn't call it a luxury. You can shop for food at a shopping mall.

We do provide welfare and food stamps for those who cant provide and they get to use the same exact grocery stores as everyone else and buy exactly the same products as everyone else. This is not the case in a medical system. Its also a silly thing to do cause we also need our public education just as we need food but dont seem to object to education being socialized. We need our fire depts like we need food, yet we dont complain that our fire depts are socialized.

I'd say eating every day is even more important than health care. Should we then have a socialized food program?

Refer to education, fire dept etc. Even national defense. Its a very false analogy.

I'd say no nation has much better health care than the U.S. There are some problems, I'll agree, but why screw it up even more by getting the government involved? Name one big government program replacing a private one that has succeeded and been more cost effective.

Ok well you are wrong then, other nations have already been judged to be BETTER. This dosent mean that the health care in the US is just shit, but it does show that IT CAN BE DONE BETTER (and this is true of even the best health care in the world) but most importantly, it can be done better while providing it for ALL citizens. Also all systems that were ranked better than the US, most were socialized systems and they ALL paid less per capita on health costs than the US does. So this tells us that the US can do it better, can do it cheaper and provide it for all.

http://www.photius.com/rankings/healthranks.html

We rank 37 in health care.

He who controls the money controls. I want to see the consumer in control, not the government.

Well there is your first problem right there. YOU ARE THE GOVT, you do CONTROL the govt and its spending. You live in a democratic system do you not? You seem to see the govt as somthing so far removed from you and your control....I dont see how a democratic system can survive if the citizenry views it as you do. That would leave us with a view of our govt as a dictator that cannot be controlled and cannot be bent to the WILL OF THE PEOPLE. Remember FOR THE PEOPLE, BY THE PEOPLE?

The consumer can control and SHOULD be in control of the tax revenue AND the govt who is elected to spend it as the CONSUMER (citizen) commands. If thats not how its working in the US, then I would guess its not actually a democratic nation and that can only be the fault of the people (consumers and citizens).

Yes it has everything to do with freedom. Talk to any doctor who wants to set up a clinic of his own. It's called a business in a free market. Talk to any health customer who wants the freedom to choose where he spends his dollars for the health care of his choice.

Well if you care so much about freedom then why no complaints about the lack of control you seem to have over your own govt and how it spends your tax money?

I have freedom to go to any doctor I want to in my socialized medical system. I have freedom to get second opinions, third opinions etc. I actually have MORe freedom in my health care choices than I did in the US. In the US I was lucky and had health insurance through my employer. I had 3 options on which plan I wanted. Once I choose a plan I am subject to all the restrictions of that plan...all 3 plans came with restrictions. They restricted what hospital I could go to and what doctors I could see. When I got a prescription I had to fill it at their pharmacy. I have had other plans that allowed you to use any pharmacy but you had to tell them exactly which one. Now when I get a prescription it is in the computer data base and ALL pharmacies can pull it up and fill it for me.

Why would a government program for the poor be sub-standard? Can't the government get it together? I have absolutely no reason to believe a government health system would be any better than a private one.

Because anything designed specifically for the poor are never well funded or delivered. People demonize the poor and view them as leeches and blame them for high taxes etc. One of the best ways to appease the public is to CUT those services first and show how you arent spending TOO much money on them. It seems that people like to view poverty as immoral or as a character defect undeserving of quality.

We cant really make any DEMANDS on a private system, we can on govt since they are using OUR money and their only function is to SERVE us as we command.

The problem is many people are irresponsible. Liberals seem to encourage that with their socialistic promises. Maybe there should be penalties for those who refuse to get catastrophic insurance. You get fined if you don't carry auto insurance.

You prove my point about how the poor are thought of. You are already starting with "irresponsible" when the fact is that many people wont be able to AFFORD it due to poverty.

Car insurance isnt the same at all. Its a luxury item that you agree to certain terms to own one. We can act like insuring our LIVES and OUR BODY is the same as a car. We can opt to NOT own a car, we cant opt to NOT live and not have a body...unless you expect people who cant afford health insurance to just go ahead and kill themselves?

How can their be "cost controls" when big business and government are mixed together?

Ah, now we are getting somewhere. You seperate them. We need numerous reforms to do that. But at least where universal health care is concerned its easy when the govt is the one funding it and sets a schedule of what they pay for services and drugs. Any company not willing to accept those price controls can feel free to not provide health care. There are PLENTY that are willing to do so.

I havent had ANY trouble getting any medications I need here and we arent paying the insane prices that people in the states are. Those companies are already settling for a bit less profit. Lets remember, they STILL PROFIT at getting reasonable prices for their products.

What do you mean your income has "NOTHING" to do with socialized medicine? Where do you think the money to run it would come from? Don't you realize that another big chunk will be taken out of your paycheck?

I mean it shouldnt have anything to do with RECIEIVING health care as an individual. We should make sure all can get their health care no matter what their financial circumstances. We pay for it as a society so that NO INDIVIDUAL circumstances a person finds themselves in would prevent it.

I agree that big business (such as Big Pharma) are in bed with the government and that is increasing our costs. We need a shake out for sure but I don't see how creating another government boondoggle is the answer.

Its one benefit of socialized medicine, it forces the unhealthy alliance between those corps and govt to reduce since we have to budget the tax money and start discussing what a FAIR price to pay really is.

I dont see universal or socialized medicine as a govt boondoggle, thats just a reflection on how badly the US citizens are doing to control the govt. The chaos in the govt is PURPOSEFUL, its what hides the corruption and helps line pockets that shouldnt be lined with US taxpayer dollars. Only the US citizenry can change that. If you are saying that it cant be changed and we have no control over the US govt, then I dont think you TRULY care about freedom or democratic systems at all ....since you are already conceeding you dont have it. Its not socialized medicine that threatens any of your freedoms, its your own lack of control over the govt and how it weilds its power and spends your money.

 

[RetiredGySgt]

Ruby said

We do provide welfare and food stamps for those who cant provide and they get to use the same exact grocery stores as everyone else and buy exactly the same products as everyone else. This is not the case in a medical system. Its also a silly thing to do cause we also need our public education just as we need food but dont seem to object to education being socialized. We need our fire depts like we need food, yet we dont complain that our fire depts are socialized.

I suggest you learn how our country works. Public Education is voted on in every district every year. Local communities decide how much money a district will get by VOTING. They determine what money is available for education, buildings, every facet of Public Education. While we are taxed for it, we vote every year on it.At the local level. Ohh and the major tax base for schools is Bonds or Property Owners. Hardly universal socialized payment.

Fire Departments in most places outside cities in this country are VOLUNTEER organizations. We do not even pay taxes for them. They conduct fund raisers and in some cases ( in the case of ambulances) charge for services rendered.

Personally I donate twice or three times a year to my local VOLUNTEER Fire Department. I live just outside the city limits so do not have automatic protection from the CITY Fire Department. I also donate to the Ambulance Service though they only do Fund raisers once a year usually.

As to food stamps, again Counties and States determine who is and who is not allowed them. And the amounts given are generally so small as to be meaningless. Again money comes from a budget VOTED on yearly by the local politicians that face reelection every couple years.

 

[Ruby]

Ruby said

I suggest you learn how our country works. Public Education is voted on in every district every year. Local communities decide how much money a district will get by VOTING. They determine what money is available for education, buildings, every facet of Public Education. While we are taxed for it, we vote every year on it.At the local level. Ohh and the major tax base for schools is Bonds or Property Owners. Hardly universal socialized payment.

Fire Departments in most places outside cities in this country are VOLUNTEER organizations. We do not even pay taxes for them. They conduct fund raisers and in some cases ( in the case of ambulances) charge for services rendered.

Personally I donate twice or three times a year to my local VOLUNTEER Fire Department. I live just outside the city limits so do not have automatic protection from the CITY Fire Department. I also donate to the Ambulance Service though they only do Fund raisers once a year usually.

As to food stamps, again Counties and States determine who is and who is not allowed them. And the amounts given are generally so small as to be meaningless. Again money comes from a budget VOTED on yearly by the local politicians that face reelection every couple years.

Public schools are paid for with TAX MONEY, that socialized. Fire depts (excluding volunteer) are paid for with TAX MONEY. The trucks are paid for with TAX MONEY. My uncle was a fireman, he was a GOVT employee and PAID for his work and his paycheck came from TAX PAYER MONEY.

Food stamps and welfare are paid for via TAX MONEY.

Socialized medicine is paid for via TAX MONEY. There isnt the difference you want to pretend there is. Face it, the US also has its own strains of socialism now.

 

[RetiredGySgt]

Public schools are paid for with TAX MONEY, that socialized. Fire depts (excluding volunteer) are paid for with TAX MONEY. The trucks are paid for with TAX MONEY. My uncle was a fireman, he was a GOVT employee and PAID for his work and his paycheck came from TAX PAYER MONEY.

Food stamps and welfare are paid for via TAX MONEY.

Socialized medicine is paid for via TAX MONEY. There isnt the difference you want to pretend there is. Face it, the US also has its own strains of socialism now.

Not the same thing and you know it, well actually I am assuming facts not in evidence, your delusions are abundant and appalling.

 

[Ruby]

Not the same thing and you know it, well actually I am assuming facts not in evidence, your delusions are abundant and appalling.

"Paid for with tax money" is the same as "paid for with tax money". Its either funded from the tax base or it isnt. I suggest health care should be paid for with tax money and give EVERYONE access just as we do with public schools.

 

[ScreamingEagle]

We do provide welfare and food stamps for those who cant provide and they get to use the same exact grocery stores as everyone else and buy exactly the same products as everyone else. This is not the case in a medical system. Its also a silly thing to do cause we also need our public education just as we need food but dont seem to object to education being socialized. We need our fire depts like we need food, yet we dont complain that our fire depts are socialized

Well then, why not pass out medical stamps just like we do food stamps? That way even the poor can go out and purchase the medical care of their choice. The point is, if our health care is a free market price will be competitive.

Refer to education, fire dept etc. Even national defense. Its a very false analogy.

How so? You made the claim that health care is a necessity and thus must be socialized. I say food is an even greater necessity. Why shouldn't we socialize food as well? And houses? And clothes? And cars?

Ok well you are wrong then, other nations have already been judged to be BETTER. This dosent mean that the health care in the US is just shit, but it does show that IT CAN BE DONE BETTER (and this is true of even the best health care in the world) but most importantly, it can be done better while providing it for ALL citizens. Also all systems that were ranked better than the US, most were socialized systems and they ALL paid less per capita on health costs than the US does. So this tells us that the US can do it better, can do it cheaper and provide it for all.
http://www.photius.com/rankings/healthranks.html
We rank 37 in health care.

How did Canada and the UK get ranked ahead of the U.S.? What exactly makes their health care systems "better"?

Well there is your first problem right there. YOU ARE THE GOVT, you do CONTROL the govt and its spending. You live in a democratic system do you not? You seem to see the govt as somthing so far removed from you and your control....I dont see how a democratic system can survive if the citizenry views it as you do. That would leave us with a view of our govt as a dictator that cannot be controlled and cannot be bent to the WILL OF THE PEOPLE. Remember FOR THE PEOPLE, BY THE PEOPLE

How about taking your personal paycheck and put it in the pot every month with all your neighbors paychecks on your block and then have you all (as the block government) decide/vote how you are going to spend all the paychecks? That would be you the CONSUMER and YOU THE BLOCK GOVT controlling things OF,FOR, AND BY THE PEOPLE. You like that idea? I didn't think so. Same principle.

The consumer can control and SHOULD be in control of the tax revenue AND the govt who is elected to spend it as the CONSUMER (citizen) commands. If thats not how its working in the US, then I would guess its not actually a democratic nation and that can only be the fault of the people (consumers and citizens).?

Government has its realm of importance. How extensive that realm becomes is entirely another matter.

Well if you care so much about freedom then why no complaints about the lack of control you seem to have over your own govt and how it spends your tax money?

You're obviously not listening to the right people. There are LOTS of us who complain about big government and its lack of finacial control and excessive spending.

I have freedom to go to any doctor I want to in my socialized medical system. I have freedom to get second opinions, third opinions etc. I actually have MORe freedom in my health care choices than I did in the US. In the US I was lucky and had health insurance through my employer. I had 3 options on which plan I wanted. Once I choose a plan I am subject to all the restrictions of that plan...all 3 plans came with restrictions. They restricted what hospital I could go to and what doctors I could see. When I got a prescription I had to fill it at their pharmacy. I have had other plans that allowed you to use any pharmacy but you had to tell them exactly which one. Now when I get a prescription it is in the computer data base and ALL pharmacies can pull it up and fill it for me.

What country do you live in? How much of your paycheck and how much of the country's budget are dedicated to health care? I understand the restrictions you had to endure under the U.S. system. That is because the insurance companies have taken over our health care and we now suffer under "managed care". I want to get them out of the mix except for straightforward catastrophic events where they can't nitpick and control the health care you are receiving.

Because anything designed specifically for the poor are never well funded or delivered. People demonize the poor and view them as leeches and blame them for high taxes etc. One of the best ways to appease the public is to CUT those services first and show how you arent spending TOO much money on them. It seems that people like to view poverty as immoral or as a character defect undeserving of quality.

If THE PEOPLE control health care (as you said), why should a core program for the poor be substandard? Why is it you claim government programs are great for everybody EXCEPT the poor people? You sound like another bleeding heart liberal who uses that old "poor" sob story in order to convince everyone how great socialized medicine is, but you really contradict yourself.

We cant really make any DEMANDS on a private system, we can on govt since they are using OUR money and their only function is to SERVE us as we command.

Yes, we CAN make demands on a private system, and far easier than with any government where you have to get a large group of people to agree and vote for change. Under a private system, if a health clinic or doctor does not respond to our demands, we can personally take our money and walk down the street and buy services from the next clinic or doctor. That's real freedom.

You prove my point about how the poor are thought of. You are already starting with "irresponsible" when the fact is that many people wont be able to AFFORD it due to poverty.

Yes, a lot of poor people are irresponsible people. You deny that? However, if we had open market health care that became competitive, prices would drop. Poor people would be able to afford health care much more easily. And if they still had a problem, they could be issued health care stamps along with their food stamps. There's no need for all of us to convert to socialized medicine just because of some poor and/or irresponsible people.

Car insurance isnt the same at all. Its a luxury item that you agree to certain terms to own one. We can act like insuring our LIVES and OUR BODY is the same as a car. We can opt to NOT own a car, we cant opt to NOT live and not have a body...unless you expect people who cant afford health insurance to just go ahead and kill themselves?

Maybe a car is a luxury where you live, but here in the U.S. it is a necessity to get around in most places. Riding a bike to work in most places here would get you killed or else take you half a day to get to work. We're not like a lot of those dinky little countries with socialized everything where you got to use a bicycle or a bus to get around cost effectively.

Ah, now we are getting somewhere. You seperate them. We need numerous reforms to do that. But at least where universal health care is concerned its easy when the govt is the one funding it and sets a schedule of what they pay for services and drugs. Any company not willing to accept those price controls can feel free to not provide health care. There are PLENTY that are willing to do so.

Yes, we do need to separate big business from government. We can do that by getting government out of health care and the lobbyists out of congress. Not by making government the primary consumer that dictates a schedule for payments of services and drugs. That's not separating them. That's government directly controlling big business. There's a name for that - it's called socialism.

I havent had ANY trouble getting any medications I need here and we arent paying the insane prices that people in the states are. Those companies are already settling for a bit less profit. Lets remember, they STILL PROFIT at getting reasonable prices for their products.

Yes, I agree the drug prices in the U.S. are crazy and a lot of the blame lies with the FDA.

I mean it shouldnt have anything to do with RECIEIVING health care as an individual. We should make sure all can get their health care no matter what their financial circumstances. We pay for it as a society so that NO INDIVIDUAL circumstances a person finds themselves in would prevent it.

Well then, I guess you wouldn't have a problem with the government providing you with food, clothing, housing, and everything else you NEED to live no matter what your financial circumstances. Frankly, you're nothing but a Big Brother advocate. And, of course, you totally ignore the fact that Big Brother makes you pay for it with increased taxation. You lose more and more control over your money….and thus your freedom…all because of them thar poor folk. LOL.

Its one benefit of socialized medicine, it forces the unhealthy alliance between those corps and govt to reduce since we have to budget the tax money and start discussing what a FAIR price to pay really is.

All socialized medicine does is make the government the master of your health care and the controller of big business. It becomes the sole dictator of what is fair or not fair instead of the market deciding. Not my druthers. It only dumbs down health care and curbs business growth. I'd rather keep my tax money in my pocket and freely spend it at the clinic or doctor of my choice in a competitive market instead of a closed system that is only eventually going to choke on itself.

I dont see universal or socialized medicine as a govt boondoggle, thats just a reflection on how badly the US citizens are doing to control the govt. The chaos in the govt is PURPOSEFUL, its what hides the corruption and helps line pockets that shouldnt be lined with US taxpayer dollars. Only the US citizenry can change that. If you are saying that it cant be changed and we have no control over the US govt, then I dont think you TRULY care about freedom or democratic systems at all ....since you are already conceeding you dont have it. Its not socialized medicine that threatens any of your freedoms, its your own lack of control over the govt and how it weilds its power and spends your money.

Yes, the U.S. does have a challenge in regard to the corruption in health care business. The industry does need a shake down, I will grant you that. Bush has proposed HSAs which I think is a good idea and a great start to change things. For younger people we need to totally eliminate Medicare and Medicaid which are going broke (failed little experiments in socialized medicine) and put health care back into the hands and control of the consumer.

 

[Ruby]

Well then, why not pass out medical stamps just like we do food stamps? That way even the poor can go out and purchase the medical care of their choice. The point is, if our health care is a free market price will be competitive.

We still run against those who dont fall below the "poverty line", we keep the beurocracy and we just end up with more uninsured and underinsured which is the problem we are facing now.

How so? You made the claim that health care is a necessity and thus must be socialized. I say food is an even greater necessity. Why shouldn't we socialize food as well? And houses? And clothes? And cars?

Cars arent really a neccessity, and for areas that it is because of the way we HAVE set our community up can be fixed to deal with that problem and I think we should. We arent having a problem with those issues like we are with health care. We should definitely provide those things (except autos) for people who truly cant provide them for themselves. Those issues arent in crisis either as health care is.

How did Canada and the UK get ranked ahead of the U.S.? What exactly makes their health care systems "better"?

Read the report.

How about taking your personal paycheck and put it in the pot every month with all your neighbors paychecks on your block and then have you all (as the block government) decide/vote how you are going to spend all the paychecks? That would be you the CONSUMER and YOU THE BLOCK GOVT controlling things OF,FOR, AND BY THE PEOPLE. You like that idea? I didn't think so. Same principle.

Well in many ways I already do. I live in a socialized nation and one that pays some of the highest taxes in the world.

Secondly my property tax is paid directly to a local "commune" and its called a "rent". My kommun (commune is just like a sub-division really) and we all determine how the money is spent. We decide what power company we will use, what garbage collection, what cable company, what internet providers etc. We even allocate the money for the beautification (planting flowers, trees, people to go around and keep the litter cleaned up, landscaping etc). We have a gym even! We also have a big laundry room people can sign up for so for those that done have machines can use and also they are good for large items like coats and comforters etc. You just sign up for 2 hour blocks.

I find it has given me MORE say and control over my money, not less.

Government has its realm of importance. How extensive that realm becomes is entirely another matter.

Well its importance is it our tool to keep our societies running smoothly and in a way that improves life for all those who live in the society.

You're obviously not listening to the right people. There are LOTS of us who complain about big government and its lack of finacial control and excessive spending.

Ok, well complaining about it isnt the same as exercizing control over the govt and as a citizen, its your duty (and mine as a citizen as well of the US) to do so. I accept my responsiblity for the mess the US govt is, as a citizen there is no way to pretend I am not.

What country do you live in? How much of your paycheck and how much of the country's budget are dedicated to health care? I understand the restrictions you had to endure under the U.S. system. That is because the insurance companies have taken over our health care and we now suffer under "managed care". I want to get them out of the mix except for straightforward catastrophic events where they can't nitpick and control the health care you are receiving.

I live in Sweden now. I pay about 35% of my pay in taxes...this will go up when my husband finishes his education in a few years and becomes a vet. We will then most likely move into the higher taxable incomes. His parents (my in-laws) are well-off and are pretty much in the highest brackets. They live quite well and dont suffer from it.

On your question about expenditures here for health care.

http://www.kff.org/insurance/snapshot/chcm010307oth.cfm

Sweden spends 2,745 per capita.
The US spends 5,711 per capita.

The US is spending more yet isnt covering everyone. Much of that problem is DUE to private markets. You cant really have a "free market" in health care and expect it to work like it would on many other commodities. Health care demand is not dictated by its price or availability...its dicated by your bodies health needs. If a person has a child who is sick and needs an anti-biotic.....they will pay whatever it takes and with whatever they have really.

One reason the US pays more is that the govt isnt putting any sort of price caps in place, they allow it to go pretty "free". The US is overcharged for almost EVERYTHING associated with health care and due to the system...its also quite heavy with beurocracy. None of that is cost effective.

If THE PEOPLE control health care (as you said), why should a core program for the poor be substandard? Why is it you claim government programs are great for everybody EXCEPT the poor people? You sound like another bleeding heart liberal who uses that old "poor" sob story in order to convince everyone how great socialized medicine is, but you really contradict yourself.

Because the PEOPLE will demonize the poor and not want to spend much money on them...its works like that. Programs like welfare, food stamps and free health care are demonized and as people are upset about the waste of their tax money and politicians needs to cut in areas...they choose programs for the poor who DONT fund their campaigns over cutting in areas that will affect big business that WILL fund their campaigns and careers.

When we all pay and all participate...then we create good quality. Whjen politicians talk of cutting health care they wont just affect the poor, they affect US ALL and therefore cant pull it off very well. The goal then becomes to be EFFICIENT and get the most you can for every penny.

Yes, we CAN make demands on a private system, and far easier than with any government where you have to get a large group of people to agree and vote for change. Under a private system, if a health clinic or doctor does not respond to our demands, we can personally take our money and walk down the street and buy services from the next clinic or doctor. That's real freedom.

No you cant, when you are sick you are not in a strong position to negotiate anything. You are competing against people with more money who will pay more when they are sick as well....no one is going to lower the price for YOU when they can make more by selling at higher rates to those who can afford and many who cant but MAKE it happen by making some other serious sacrafices and go into debt trying. *some people have lost homes, college funds etc*

You arent going to have a clinic down the street ready to give you better rates and pharm companies arent all that easy for a small guy to start. Health care isnt driven by demand and supply rules as other things are. Health care is more unique than that and has its own elements that take it out of that realm. You dont go to the doctor because its cheap, you go because you are sick.

Yes, a lot of poor people are irresponsible people. You deny that? However, if we had open market health care that became competitive, prices would drop. Poor people would be able to afford health care much more easily. And if they still had a problem, they could be issued health care stamps along with their food stamps. There's no need for all of us to convert to socialized medicine just because of some poor and/or irresponsible people.

Yes many poor people are irresponsible, so are many middle class people and so are many rich people. Its a bit ridiculous to punish only poorer folks for a human nature that we ALL have at times and to varying degrees. Also, most wealth is inherited, not earned. That means that those with more wealth are not inherently more deserving because they are more responsible...its the luck of birth.

An open market on health care is not going to bring rates down, as I already said...its not subject to the same supply and demand rules and effects many other industries are. It has unique features that make that a fact.

I also grew up with the manta that free markets are the answer to everything. It is the answer for many things, but not all things. We go to extreme with it just as communism goes to extreme with socialism.

Maybe a car is a luxury where you live, but here in the U.S. it is a necessity to get around in most places. Riding a bike to work in most places here would get you killed or else take you half a day to get to work. We're not like a lot of those dinky little countries with socialized everything where you got to use a bicycle or a bus to get around cost effectively.

That is somthing that can be rectified. We can certainly have busses, trains, subways and bike routes etc. Its better for the environment, its relieves some dependence on oil, it helps people get more active (walking to bus stops, from stop to home or work, bikes etc)....and its cheaper!

You dont have to be a small country either. You just break it down into the managable sizes (zones) and create the mass transit system. It provides jobs as well! Not just to build it, but also to maintain it and run it.

Yes, we do need to separate big business from government. We can do that by getting government out of health care and the lobbyists out of congress. Not by making government the primary consumer that dictates a schedule for payments of services and drugs. That's not separating them. That's government directly controlling big business. There's a name for that - it's called socialism.

Yes, well I am advocating a socialist program here. Its not a dirty word as you seem to imply...just as capitalism, privatization, or free markets are not dirty words. We need a mix of all those concepts in the right places.

Separating the govt from big business would entail more than a socialist program, on that I agree. It would have to be done with reforms on elections and donations to elections....rules on private investment for politicians as well as conflicts of interest and rules limiting the possibility for them to go in and out of the public to private sector (they join the public sector to do favors for private corps for promises of a job in the private sector and do so numerous times creating a revolving door that gives them influence they shouldnt have and that they use for those private business interests).

Yes, I agree the drug prices in the U.S. are crazy and a lot of the blame lies with the FDA.

Its more than the FDA, the FDA is a tool for companies for certain but so is the rest of the US govt (which is our fault). The problem is that our govt wont place price restrictions on them as well as other safety restrictions or business practices that jeprodize our health and health care.

http://www.detnews.com/apps/pbcs.dll/article?AID=/20070830/OPINION01/708300314/1008

Some doctors not surprisingly said the payoffs were appropriate and that patient care was not sacrificed. The practice, they say, has been going on for years and is "widely accepted."

Perhaps that's the problem. Payoffs have been great for doctors who supplement their incomes and now see it coming from competing interests, but the practice hasn't lowered costs for consumers or gotten much needed generic drugs to the people who need it most.

I also dont believe that such practices havent impacted our health care. If a doctor has an incentive to prescribe a particular drug...that has an influence and the ONLY influence should be what the is BEST for the patients health.

http://www.nytimes.com/2007/06/03/health/03docs.html?ex=1189742400&en=0c2a0b10ce4eccd8&ei=5070

One of Dr. Abuzzahab’s patients was David Olson, whom the psychiatrist tried repeatedly to recruit for clinical trials. Drug makers paid Dr. Abuzzahab thousands of dollars for every patient he recruited. In July 1997, when Mr. Olson again refused to be a test subject, Dr. Abuzzahab discharged him from the hospital even though he was suicidal, records show. Mr. Olson committed suicide two weeks later.

Well then, I guess you wouldn't have a problem with the government providing you with food, clothing, housing, and everything else you NEED to live no matter what your financial circumstances. Frankly, you're nothing but a Big Brother advocate. And, of course, you totally ignore the fact that Big Brother makes you pay for it with increased taxation. You lose more and more control over your money….and thus your freedom…all because of them thar poor folk. LOL.

Well I certainly dont need or want the govt to provide everything. You are now dealing in extremes...the ALL one way of ALL the other way. Its a false premise.

I am well aware that socialization means more tax money, I pay those higher taxes. But then I also look at expenditures I dont HAVE because they are provided from the me and other tax payers and I am happy about it. For instance, college here is free. Its merit based, you must have the grades each program requires to get in. I dont have to save for my sons college, (or my own should I choose to go)...he must earn it on his own.

Day care is subsidized, I didnt live here when I had need but it would have been nice and I am glad to see families have that available. My son will hopefully one day have his own family and I am glad that he will have this. We also pay for parents to have 1 full year at home with a new baby (to be split between them). Its support of families..a new family dosent have to worry about the health care aspect nor day care AND can be at home with the baby for the first year as well without losing their job and also have their income. It makes for a less stressful society and it gives kids a GREAT start in life. My taxes on this are well spent.

EVERYONE can participate, these programs are not reserved for the poor...even the RICHEST citizens also use these same programs. They arent income based. That is my point about a social program, its for EVERYONE.

My husband is swedish and grew up here, his family are well off and he used the same health care systems, the same day care systems, the same schools etc as lower incomed people in sweden do. The biggest difference for my husband is that he could have more luxuries because his family had more disposable income than some others.

The owners of H&M are swedish and they all live here. They use the same health care I do, their kids also have to have the grades to get into college here and if my son has better grades he would get the spot before their kid would....they would use the same daycares we all do and pay the same rates we all do. It dosent matter that they are very rich....all those services are there for them just as they are for me and even the person who makes less than me.

All socialized medicine does is make the government the master of your health care and the controller of big business. It becomes the sole dictator of what is fair or not fair instead of the market deciding. Not my druthers. It only dumbs down health care and curbs business growth. I'd rather keep my tax money in my pocket and freely spend it at the clinic or doctor of my choice in a competitive market instead of a closed system that is only eventually going to choke on itself.

Well you are incorrect as the evidence shows. It is the US system that is choking and in crisis. Sweden pays less than the US does for health care. I have choice in my doctors, I am not limited there. I can choose whatever health facility I want and I am not restricted to ONLY go there nor am I restricted to a specific hospital either.

There isnt a competitive market in medical care in the US, there is a corrupt and predatory one. I must repeat that "free market principles" dont apply to the health care industry due to the fact that it is not a market that is dictated by supply demand formula.

Yes, the U.S. does have a challenge in regard to the corruption in health care business. The industry does need a shake down, I will grant you that. Bush has proposed HSAs which I think is a good idea and a great start to change things. For younger people we need to totally eliminate Medicare and Medicaid which are going broke (failed little experiments in socialized medicine) and put health care back into the hands and control of the consumer.

Welfare programs like medicare and medicaid arent failed socialized medicine...if they were socialized then they would be servicing ALL citizens (and not JUST poor ones).

As I have stated and your examples illustrate rather well....programs that are designed specifically for the poor tend to be underfunded and the first thing we want to cut to save tax money. The poor are the most unheard group of all with the least amount of power as well. It is better to create programs that they have equal access to, so that they can also benefit from the quality systems we create for ourselves.

*btw, there are numerous parts of the swedish socialized system that are privatized but they are paid for their services by the govt and must adhere to the price schedules and standards of practice. A mixture between socialization and privatization is a good thing. This socialist nation is a mixture of both in many areas.