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I agree with pretty much all you've said here, with the exception of those stricken with genetic or unavoidable illness being held responsible for a greater amount of the costs of their care.
I can vouch, for a fact, that many people here in Canada abuse the healthcare system for services that they either do not need or that they should be paying for out of their own pocket. We have people who visit emergency rooms for cuts, scrapes, the sniffles, etc. and we have doctors prescribing antibiotics or OTC drugs like Tylenol inappropriately, thus wasting ever scarcer healthcare dollars.
I've always said and written to government before suggesting two things that would make our system more efficient and more effective. One, every Canadian should be given a "credit balance" of a to be determined amount that allows that Canadian to access whatever healthcare services they choose - some may choose dental care, or eye care, or chiropractic care, etc., all of which aren't currently covered, and others may choose different services or products from a menu. In that way, each Canadian will have an equal ability to get healthcare services that are important to them personally and not just what the government thinks is the appropriate mix. Two, I'd like to see every Canadian receive a "bill" quarterly, semi-annually, or annually, that simply itemizes the healthcare services they accessed in that year and the costs of each of those services. Most if not all Canadians today haven't a clue what the costs are for each of the services they access - they just no it doesn't cost them anything out of pocket. If they knew that getting a prescription for Tylenol cost the system about $100 when it only costs about $10 at the pharmacy, the responsible ones amongst us may think twice about how we consume healthcare.
Well unless your making millions upon millions of dollars not using a single deduction you will never pay that much even the richest in Canada pay a maximum of 50% for almost everyone else you pay much less than 50% around 20-30%. That is reasonable it pays for all of our services and still allows us to save for retirement. If we couldn't spend any money we wouldn't have one of the best economies now would we?
Ah, so the majority of the people in Canada are essentially not paying for the services provided and riding the backs of the rich. That seems vaguely familiar like I have seen it before, but where? Oh right, in the US. Have you ever wondered why you have decided to support a government that takes in 30% of your income? When it become acceptable to the people that their fruits of their labor was the property of the state? When did it become acceptable that the only thing the people can do is insist the government not take it all? Did you ever wonder why you accept the notion that the government has access to any amount of your money they see fit? Why is it, that the only argument you seem to have is that your money goes to services? Is it not true to say that you could spend your income on services yourself? Is it not true to say that when you spend your own money towards services you need everyone involves agrees to the transaction? Can you say the same for your idea?
Where did you get that the rich pay for everyone else, it is simply not the case. It's is what we accept as being Canadian. We pay much more than Americans as we believe everyone should have fair and equal access to services they need.
Why should they have equal access to services they need? Is it not your duty in this life to meet your own needs? Why is it that individual needs of the people are the task of the state to meet? Why is it not yours?
I also do not see how your argument follows. If the rich are paying the majority of the cost, as your argument suggests, then it makes little sense to say you are covering your share. If however you were covering your share then why not just pay for it on the open market? Why even look to the government at all?
Ah, so the majority of the people in Canada are essentially not paying for the services provided and riding the backs of the rich. That seems vaguely familiar like I have seen it before, but where? Oh right, in the US. Have you ever wondered why you have decided to support a government that takes in 30% of your income? When did it become acceptable to the people that their fruits of their labor was the property of the state? When did it become acceptable that the only thing the people can do is insist the government not take it all? Did you ever wonder why you accept the notion that the government has access to any amount of your money they see fit? Why is it, that the only argument you seem to have is that your money goes to services? Is it not true to say that you could spend your income on services yourself? Is it not true to say that when you spend your own money towards services you need everyone involves agrees to the transaction? Can you say the same for your idea?
Health care is not a market because it is not selling interchangeable commodities between disinterested parties who treat each other like equals. If you are sick, you are sick, and not in a position to haggle with your doctor over pricing, you don't often have time to comparison shop, and you don't have a lot of time to do research.
When your mechanic says "your engine is shot," you may be ticked off but you can still make a rational decision whether to rebuild the engine or replace the car. When your doctor tells you "you have cancer, and there's a 50% chance that you will be dead in 6 months," you're not going to be rational about it. Not a chance.
It's called society we have an obligation to take care of the others in our society as it ultimately benefits us if everyone succeeds. The rich (which in Canada is anyone who makes around 130,000$/year apparently) are not paying the majority of the cost though unlike America.
I agree with pretty much all you've said here, with the exception of those stricken with genetic or unavoidable illness being held responsible for a greater amount of the costs of their care.
I can vouch, for a fact, that many people here in Canada abuse the healthcare system for services that they either do not need or that they should be paying for out of their own pocket. We have people who visit emergency rooms for cuts, scrapes, the sniffles, etc. and we have doctors prescribing antibiotics or OTC drugs like Tylenol inappropriately, thus wasting ever scarcer healthcare dollars.
I've always said and written to government before suggesting two things that would make our system more efficient and more effective. One, every Canadian should be given a "credit balance" of a to be determined amount that allows that Canadian to access whatever healthcare services they choose - some may choose dental care, or eye care, or chiropractic care, etc., all of which aren't currently covered, and others may choose different services or products from a menu. In that way, each Canadian will have an equal ability to get healthcare services that are important to them personally and not just what the government thinks is the appropriate mix. Two, I'd like to see every Canadian receive a "bill" quarterly, semi-annually, or annually, that simply itemizes the healthcare services they accessed in that year and the costs of each of those services. Most if not all Canadians today haven't a clue what the costs are for each of the services they access - they just no it doesn't cost them anything out of pocket. If they knew that getting a prescription for Tylenol cost the system about $100 when it only costs about $10 at the pharmacy, the responsible ones amongst us may think twice about how we consume healthcare.
Any declarations towards the existence of a such thing called society is and will forever be fallacious. There is only individual men and women with their own individual rights. Nothing else.
I have little reason to believe that the amount you pay in covers your care as it is very clear the largest sum comes from the rich.
Rights cannot exist and are irrelevant without society. Society creates rights.
No, it is not because men has established governance, made law, or dreamed up concepts such society, that life, liberty, and property exist. It is fact, because life, liberty and property existed beforehand that man established governance, made law, or dreamed up the concept of society. Without life, liberty and property no one would have thought to establish (or frankly have the ability) a collective organization to protect their individual right to lawful defense.
Exactly you have to have a society for rights to work and you must function as a part of that society. It is the job of government to create laws to benefit society.
Lets see if I can explain this. The reason the people have a right to lawful defense is from the very fact that very man has the right of defending, even by force, his person, his liberty, and his property. The very reason the people have in defending the government existence and where it gets its lawfulness is from this individual right. This means very clearly that just as individuals can not act on the person, liberty, property of each other neither than can the government thats it's reason for existence is to protect it. This also means that the government can have no other duty sworn upon it as it would conflict with it's already established mission. The very fact that the government has awarded itself and we have sworn upon it other duties means that the government is failing it's mission and have no reason to support it's existence.
In short, government does not exist for this thing you call society, but for individuals with the duty of protecting their rights and it can not serve no other purpose without coming into conflict with the peoples rights. Like I said, there is nothing except people and their rights. Everything else is merely an abstraction.
There is no such thing as right to property. Rights do not exist without society and must be created by the people; government exists to benefit society.
FYI, the actual effective tax rate in the US is a bit lower than that, and has been dropping since the Reagan years -- especially for high earners.Have you ever wondered why you have decided to support a government that takes in 30% of your income?
American citizens have been taxed since Day 1. Income taxes were discussed as early as 1814, imposed in 1861, and passed SCOTUS review in 1895.When did it become acceptable to the people that their fruits of their labor was the property of the state?
1) Tax rates have been falling since the 80s.When did it become acceptable that the only thing the people can do is insist the government not take it all?
Did you ever wonder why you accept the notion that the government has access to any amount of your money they see fit?
Governments require revenues. Even the guys who run the printing presses cannot conjure the money required to run a government out of thin air without devastating consequences.
It is not.Is it not true to say that you could spend your income on services yourself?
You are likely to spend on services that directly affect you, but a society with 300 million people cannot work on such a self-centered basis. E.g. if a product enters the US in Los Angeles and is trucked across the US, it's going to involve a whole host of services that a recipient in Maine won't even realize require funding.
Is it not true that masturbation is sex with someone you love?Is it not true to say that when you spend your own money towards services you need everyone involves agrees to the transaction?
You cannot have a society which allows for differences of opinion, where every single person consents to every single law, transaction and regulation. Nor are broader goals, like keeping National Parks open for all citizens, compatible with a system where "you only pay for the services you agree to."
In fact, that compulsion is part of the point of protection. E.g. A meatpacker may be upset that he is required to follow a series of steps to prevent bacteria from entering his product, and thus does not consent to it. What is more important -- his right to handle his property as he sees fit, or ensuring that the meat he produces is safe?
Sure, if we accept such a ridiculously narrow interpretation of the role of government, that might make sense.This also means that the government can have no other duty sworn upon it as it would conflict with it's already established mission.
Yes, except for that pesky thing where it is the citizens who are telling the government what to do.The very fact that the government has awarded itself and we have sworn upon it other duties means that the government is failing it's mission and have no reason to support it's existence.
"This thing you call society?" Wow, you really are planning to live on your own island, aren't you?In short, government does not exist for this thing you call society
Yeah, except that "rights" are also an abstraction. In fact, they are social constructs, like language or marital roles.there is nothing except people and their rights. Everything else is merely an abstraction.
So your argument basically amounts to that people do not have sovereignty over their own own body and by extension everything in which that body acts upon. That for some strange and unusual reason they only gain rights by the permission of their peers. You realize that defeats the entire purpose, right?
Oh here we go again, with the absurd notion that healthcare can't work in the free market because of evil people, but the government is made up of people of a finer cloth and their oversight(read control) will make everything all better. For some reason I doubt it.
“If the natural tendencies of mankind are so bad that it is not safe to permit people to be free, how is it that the tendencies of these organizers are always good? Do not the legislators and their appointed agents also belong to the human race? Or do they believe that they themselves are made of a finer clay than the rest of mankind?” - Frédéric Bastiat
Yes, it's so much better to keep people out of the health care system because they can't afford it, or to (literally) bankrupt people when they have a severe medical condition, than to have citizens wait for non-emergency or non-critical procedures.
One article from 2006 qualifies as "research?" Good to know.
Who has won Nobels since then? Several Americans -- but also French, German, and Japanese doctors. Discovery of HIV? France. In vitro fertilization? UK. And as already mentioned, a lot of US R&D is not going into critical life-saving care. Nothing mentioned in that article suggests that other nations do not pay for commercialized medical innovations. And again, it is very apparent that Americans are not getting twice as good of care as nations with UHC.
And what about medications like Zaltrap? It extends the lifespan of a colon cancer patient by about 42 days... at a cost of $11,000 per month. Oh, and you have to take it for at least 7 months to be effective. Oh, and it is equally as effective as Avastin, which "only" costs $5,000 per month. Oh, and Medicare is required by law to offer it -- without the ability to negotiate on price. (The Rising Costs of Cancer Drugs -- New York Magazine)
Or, think of it in free market terms. What is the goal of a company like Pfizer? To earn returns for their shareholders; the fact that they do so by offering medications is secondary. So how strong are the incentives to spend billions tackling antibiotics -- which are expensive to develop, best used only once to treat a condition, need to be used sparingly to maintain their effectiveness longer, and are usually around $200 for a course -- compared to the incentives to treat chronic conditions that mean years of purchases (like high blood pressure)? Or to find another boner pill? (see Dr. Charles Knirsch: “These Are Not Ruthless Decisions” | Hunting the Nightmare Bacteria | FRONTLINE | PBS and Who’s Trying to Fix the Pipeline Problem? | Hunting the Nightmare Bacteria | FRONTLINE | PBS and Dr. John Rex: The Drug Pipeline Is “Very, Very Thin” | Hunting the Nightmare Bacteria | FRONTLINE | PBS)
Next time... do your research on the alleged bounties of all the R&D.
I agree it is not viable as a sole proxy. However, in a system where mothers get better pre-natal care, and are better taken care of for other reasons (e.g. better safety nets), infant mortality rates will be lower. Hence it is used as one of many indicators.
Like this? Cancer Rates and Unjustified Conclusions
I also really like how you reject infant mortality rates as an indicator, and adopt the much more complex cancer survival rate as a viable indicator....
Uh. Hello? Did you not actually read what I wrote?
The reason why drugs are cheaper in Germany is because the German government buys the pharmaceuticals they will distribute to their citizens, and with that purchasing power negotiates lower prices with the pharma companies.
That is NOT an option in the "free market" US. Not only is it not an option, the Republicans denied that ability to Medicare when they instituted Part D. (The VA, which is allowed to negotiate, pays about 40% less for drugs than Medicare Part D recipients.)
Contrary to popular opinion, neither the pharmas nor the German government are rife with idiots. If they realize that German shops are selling large volumes of drugs to the US, it's the companies -- not the US government -- that will take notice, and do everything they can to jack up German prices.
Some US regulations do interfere with prices. But in most cases, those regulations aren't designed to protect patient safety or increase drug availability. They prop up the pharmaceutical companies... and make the drugs more expensive. For example, before *cough* the ACA, patent protection for biologic drugs was indefinite. This was a huge boon to the manufacturers, as the biologics were also (surprise!) phenomenally expensive; a drug like Remicade can list for $5000 a dose just for the medication alone (it's an infusion, and must be done at a facility), and a patient may need 4 doses per year. Care to guess who lobbied to keep generic biologics out of the ACA?
This is not a "free trade" issue. It is not trade policies that makes drugs cheaper in Germany. It is their universal health care policies that make the drugs cheaper.
Uh, yeah, that would be a convincing argument if goods like food and autos weren't *COUGH* regulated in the US.
Health care is not a market because it is not selling interchangeable commodities between disinterested parties who treat each other like equals. If you are sick, you are sick, and not in a position to haggle with your doctor over pricing, you don't often have time to comparison shop, and you don't have a lot of time to do research.
When your mechanic says "your engine is shot," you may be ticked off but you can still make a rational decision whether to rebuild the engine or replace the car. When your doctor tells you "you have cancer, and there's a 50% chance that you will be dead in 6 months," you're not going to be rational about it. Not a chance.
I'm not sure if you know what the difference between rhetoric and fact is, but "factchecker.org" is engaging in the former not the latter in the article. Their basic argument, is two fold; One: the US has better cancer survival rates, but the uninsured fare worse then the insured (what does this have to do with anything? the metric is for overall cancer survival rates, so its pretty sad that we do better with part of our population uninsured then they with their entire population insured) and two: that we just detect cancer earlier but that doesn't mean anything. What!?!?!?!?! Early detection doesn't mean anything? They must not be checking the facts over at fact checker because, how early it gets caught is the NUMBER ONE PREDICTOR OF SURVIVAL FOR EVERY SINGLE ****ING TYPE OF CANCER. Second, that's pretty damning to say that countries with UHC detect cancer at later stages then we do. I thought they had world class healthcare? :lamoFor breast cancer, for instance, the U.S. survival rate was 83.9 percent, the U.K. rate was 69.7, and the average European rate was 73.1.
I agree with pretty much all you've said here, with the exception of those stricken with genetic or unavoidable illness being held responsible for a greater amount of the costs of their care.
I can vouch, for a fact, that many people here in Canada abuse the healthcare system for services that they either do not need or that they should be paying for out of their own pocket. We have people who visit emergency rooms for cuts, scrapes, the sniffles, etc. and we have doctors prescribing antibiotics or OTC drugs like Tylenol inappropriately, thus wasting ever scarcer healthcare dollars.
I've always said and written to government before suggesting two things that would make our system more efficient and more effective. One, every Canadian should be given a "credit balance" of a to be determined amount that allows that Canadian to access whatever healthcare services they choose - some may choose dental care, or eye care, or chiropractic care, etc., all of which aren't currently covered, and others may choose different services or products from a menu. In that way, each Canadian will have an equal ability to get healthcare services that are important to them personally and not just what the government thinks is the appropriate mix. Two, I'd like to see every Canadian receive a "bill" quarterly, semi-annually, or annually, that simply itemizes the healthcare services they accessed in that year and the costs of each of those services. Most if not all Canadians today haven't a clue what the costs are for each of the services they access - they just no it doesn't cost them anything out of pocket. If they knew that getting a prescription for Tylenol cost the system about $100 when it only costs about $10 at the pharmacy, the responsible ones amongst us may think twice about how we consume healthcare.
I'm not saying "there is no gap." I'm saying that big chunks of that gap are dedicated not to improving care, but to improving pharma company profits.You still haven't discredited the R&D gap between US and Europe as a whole....
Not really. They are discussing the nuances involved when comparing cancer survival rates -- much in the same way you tried to introduce the nuances of comparing infant mortality rates.I'm not sure if you know what the difference between rhetoric and fact is, but "factchecker.org" is engaging in the former not the latter in the article....
Roughly 15% of the US is currently uninsured. (Also, the ACA is trying to reduce the number of uninsured; the article is partly written to respond to critics of the ACA.) I'd say that group matters.Their basic argument, is two fold; One: the US has better cancer survival rates, but the uninsured fare worse then the insured (what does this have to do with anything?)
It's not that it doesn't mean anything. It's that it influences the "five year survival" statistic, in a way that does not necessarily describe outcomes properly. And yes, there have been quite a few doubts raised recently about the value of early detection, especially with breast cancer.that we just detect cancer earlier but that doesn't mean anything. What!?!?!?!?! Early detection doesn't mean anything?
No, it really isn't. Frequent screenings can also result in false positives; prostate cancer outcomes don't necessarily improve because you caught it early; ovarian and pancreatic cancers have high mortality rates, no matter when you catch it.They must not be checking the facts over at fact checker because, how early it gets caught is the NUMBER ONE PREDICTOR OF SURVIVAL FOR EVERY SINGLE ****ING TYPE OF CANCER.
So if I have a heart attack, I should tell the EMT's to take me to see a doctor in the morning because it's cheaper? Yeah, that's the ticket.You may not be able to haggle over your doctor over price, but most people are smart enough to know that a hospital is going to cost more then a clinic, whether they are sick or not.
And for the third time: Those drugs are cheaper in other countries because THEIR GOVERNMENTS, AS THE PRIMARY PURCHASER OF MEDICATIONS FOR THEIR UNIVERSAL HEALTH CARE SYSTEMS, NEGOTIATE LOWER PRICES WITH THE PHARMACEUTICAL COMPANIES.Everything is regulated in the world, but what those regulations are matters here. And our regulations prevent us from importing drugs from other countries (like they import from us)
First you pretended like there was no difference in R&D and acted like other countries are our equivalents in innovation in the industry.I'm not saying "there is no gap." I'm saying that big chunks of that gap are dedicated not to improving care, but to improving pharma company profits.
Besides, the US spent around $2.7 trillion on healthcare in 2012; somewhere between $200 and $300 billion of that was R&D. Higher R&D does not account for the US spending twice the OECD average on healthcare, as a percentage of GDP.
Sorry I didn't mention that earlier. My bad.
Here's the NY Times' take on why we spend so much more on health care than other systems. Spoiler alert! Higher spending on R&D isn't mentioned. http://www.nytimes.com/2013/06/02/h...ds-the-world-in-health-expenditures.html?_r=0
Like I said, if our average cancer survival rate is higher with only 85% of the population insured vs. their survival rate with 100% insured, what does that say about quality?Roughly 15% of the US is currently uninsured. (Also, the ACA is trying to reduce the number of uninsured; the article is partly written to respond to critics of the ACA.) I'd say that group matters.
Looking at overall cancer survival rates across the board, it becomes quite clear that the US is at the top of nearly every statistic. The same cannot be said for every other country. For example, while Canada only has a 9% higher mortality rate for breast cancer, it has a 184% higher mortality rate for prostate cancer than the US. 10 Surprising Facts about American Health Care | NCPAPlus, the article points out how several nations with UHC match US survival rates: Canada, Japan, Cuba, and Australia.
So find me a better statistic then.It's not that it doesn't mean anything. It's that it influences the "five year survival" statistic, in a way that does not necessarily describe outcomes properly. And yes, there have been quite a few doubts raised recently about the value of early detection, especially with breast cancer.
You're right, pancreatic cancer is deadly. You still have a 14 times better chance to survive if you catch it stage one as opposed to stage four. This is where your argument continues to fall apart, you base your arguments far too much on sumarizing facts and statistics rather then looking at the intrinsic details which they possess.No, it really isn't. Frequent screenings can also result in false positives; prostate cancer outcomes don't necessarily improve because you caught it early; ovarian and pancreatic cancers have high mortality rates, no matter when you catch it.
New guidelines encourage reducing the rates of certain types of cancer screenings, including for breast, cervical and prostate cancers. Routine screening is not recommended for many types of cancers, including bladder, ovarian, pancreatic or testicular cancer.
Chronic conditions account for 75% of healthcare spending. CDC - Chronic Disease - At A GlanceSo if I have a heart attack, I should tell the EMT's to take me to see a doctor in the morning because it's cheaper? Yeah, that's the ticket.
And for the third time: Those drugs are cheaper in other countries because THEIR GOVERNMENTS, AS THE PRIMARY PURCHASER OF MEDICATIONS FOR THEIR UNIVERSAL HEALTH CARE SYSTEMS, NEGOTIATE LOWER PRICES WITH THE PHARMACEUTICAL COMPANIES.
If we buy drugs from Canada and Germany, we're benefitting from lower costs BECAUSE THEY GOT THOSE LOWER COSTS BY ADOPTING UNIVERSAL HEALTH CARE SYSTEMS.
Sorry to "shout," but this critical aspect of lowering the prices is apparently not getting through to you.
The US cannot simply contract with drugstores in Germany and magically get better prices. The pharma companies will not offer favorable pricing to Germany if 2/3 of what is sold to Germany winds up in the US, and undercuts their own high-margin US sales.
Or, how about this: Why don't you tell me why medications are cheaper in Germany than in the US? Go ahead, do a little research, and after that, try to explain how importing drugs from Germany is a long-term solution to drug prices.
it was built by a private company hired by obama admin with unrealistic demands and deadlines from the obama admin
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