Universal Healthcare in America

[Cainhurst Crow]

The american healthcare system is a problem and it does require a fixing, however, universal healthcare would bankrupt the system. Medicare and Medicaid are semi-subsidized and these two programs are some of the biggest costs to the current budget of the united states. At 1.05 trillion dollars in 2015, it was the second biggest source for US debt after the Social Welfare programs, which was 1.28 billion. Compared to the military spending, 610 billion, both programs cost nearly double what many people assume is the most well funded program the Us focuses on. The fact of the matter is, is that because of population, universal healthcare just wouldn't be feasible.

We have 318 million people, and growing. The UK, our closest comparable equivalent, has only 64 million residents. Most of these countries who have universal health care, do not have populations that exceed even 100 Million. We're talking about applying a system that works for what would be a fraction of the populace. At 55 Million people on medicare right now, and 65 million on medicaid, we have more people on government funded or government assisted medical health coverage than the entire populations of most of the other countries who have universal healthcare. Whats more telling as well is how they talk about their health care programs having too many people in it already, how they say it takes forever to see anyone medically, and how when even a couple thousand more people join the system it throws their entire economic balance into chaos, as we have seen with the latest rhetoric around the refugees.

The reality of the situation is that universial healthcare as has been defined by the world, that being the government covering everyone, is a pipe dream. It would require gutting the other social welfare programs to sustain that magnitude of individuals, and it would destroy the entire budget of the military to 0 dollars in order to keep such a system funded. The only way everyone is going to get coverage in the united states is if the government and corporations work together in order to get people covered. Thus, the current system that we have. Short of losing 3/4's of the population overnight, that will not be changing in the immediate future.

 

[Green Ranger]

As a percentage of GDP, america spends less than most nations on healthcare.

Per capita, its about double the expenditure of almost every other nation except switzerland, but the cost is split almost 50/50 between public and private.


Im no expert on the matter but generally it seems that due to a number of factor, privatization is far more expensive in the long haul vecause theres a shitton of redundant overlap that just doesnt need to be there.

The real issue for america is that its shirked its responsibility to its citizens for so long and relied on the private sector so much that transition to universal healthcare is going to be fucking expensive in the mid term, because lack of infrastructure means that demand is going to outpace supply.

Is that a reason to not do it? frankly, no, because the US needs to start treating its citizens better (particularly the lower and working class in gerards to this) sooner or later, because the more they punish the poor, the more the foundations of their economy erode. They've gotta start investing at the bottom again instead of relying on the trickle-down, and stopping people from bankrupting themselves in order to get often life-saving treatment is a good start IMHO.

 

[Brandon Rhea]

One of the reasons current US healthcare programs are so expensive is drug and treatment prices. We don't really have a health care system after all. It's more of a disease management system. In a private health insurance and pharmaceutical market, the incentive is for disease treatment because you can make massive profits off of that (and drug companies do indeed make massive profits). In a healthcare system in which the taxpayers are on the hook, and costs need to be managed, the incentive switches towards disease prevention, which is ultimately cheaper than disease treatment. Not to mention it also increases the standard of living in general.

 

[GABA]

The perfect situation for economists would be if sick people are not cured but still treated so they can continue working or 'function'. And if we can mannage to get everyone on some sort of meds well that's just perfect. You might not be able to easily increase your market share, so lets increase the size of the market. That increases your revenue stream and leads to more profit.

That is also why side effects are actually a good thing. You can sell complementary medication to counteract them. Win.

This is like some crazy conspiracy stuff here...so lets talk about drug research and diseases.

The reality of the situation is: there are numerous diseases that will never be curable. This is not because someone is looking to make money, its just the reality of nature on a fine genetic level of competing organisms that makes it difficult to even provide effective treatments. There is not going to be ever a magical pill or medicine that will cure you of your alignments. The word cure could even be best described as a buzz word and be super cautious when you see it in the media. Though, you might say, but GABA, what about vaccines? Well, vaccines is preventative medicine, not a cure, since we're assisting in preventing the disease from occurring; otherwise if you get that disease, you would have to be submitted to treatment (which is why you take 10 days of antibiotics for a bacterial infection, but are not necessarily cured from getting said bacterial infection again.)

Today's drug research is still fairly young in its methods and not to mention its an ever changing battle because we deal with biology and with biology we have to remember everything evolves to be the fittest in society, including the disease itself (please note, I am using 'disease' as an all encompassing term here). Cancer is difficult to find effective treatments because we are looking at it from a genetic level and everyone's biology is different. Then we also have mental illness which is taboo in our society so finding effective treatments is beyond just a biological level, its also the funding at the research level too. Drug research also takes a minimum of ~7 years before it even reaches human trials. This includes just getting the ok from a peer review board to conduct the research and having to get the ok from the FDA, its a long, long grueling process; and most of the time, in this research, it doesn't even get to human trials. Lets also not forget how freaking expensive it is to do drug research.

The side effect for all drugs allowed by consumer use is death, even those two Tylenol you take for your pain (which doesn't cure, it treats), has the side effect of death. If there are too many side effects for a drug, where its worse to take the drug than actually live with the disease, it is rejected by the FDA. I also would like to mention that regardless if the side effect is caused by the drug or not, it is included on the list of side effects. Someone could come in, help with the trial and reports that they got liver cancer from it...though it probably wasn't from the drug, it still has to be included on the list. In research we also call these outliers, but they still have to recognized in research. This is something to keep in mind though about side effects and remember its the researches who report this and up to the boards to decide to put it out on the market, not the economists.

So why do we have side effects? We are actually not that advanced in medicine yet and we are still pretty much treating the body as a whole rather than its individual parts. An example I like to use is putting motor oil into your vehicle; in order for it to run great you need to add oil in the right part. Making this super simple here..but if we look at our bodies like a car's engine and oil as the medicines, basically we just pour the oil all over the engine, hoping some will get to the right spot, this is where we are in medicine. This is why we have side effects because clearly oil doesn't need to go in the coolant or the windshield wiper fluid, but it does and its not going to react well; just like when we take medicine, its affecting our body as a whole and not its individual parts. Once we're able to effectively treat individual parts, I will be giving a whole different conversation here.

Sometimes extra drugs are prescribed to combat some nasty side effects, since sometimes there just is no other medication on the market for some diseases and there are some people out there who need it and can't function in society without it. However, if people are having side effects that are impacting their livelihoods, they don't have to live with it. Generally there are multiple medications on the market and one may work better than the other, which is why (and often costly, I do understand that) you have to communicate with your doctor about what is wrong.

So...this is not denying that when drugs that are successful and with minimal side effects do come out there is a nice price tag, and not denying either that there are some out there who are greedy bastards, but a lot of the side effects and drug creation is not an inside job. And to be honest, I would rather work for a pharmaceutical company rather than have my own private practice due to the insurance companies having way too much say how much time you spend with your clients.

 

[Raydo]

WebMD is universal and you dont pay a dime. I mean sure you get told you have cancer every time you get a headache but #worthit

 

[Mr.BossMan]

This is like some crazy conspiracy stuff here...so lets talk about drug research and diseases.

The reality of the situation is: there are numerous diseases that will never be curable. This is not because someone is looking to make money, its just the reality of nature on a fine genetic level of competing organisms that makes it difficult to even provide effective treatments. There is not going to be ever a magical pill or medicine that will cure you of your alignments. The word cure could even be best described as a buzz word and be super cautious when you see it in the media. Though, you might say, but GABA, what about vaccines? Well, vaccines is preventative medicine, not a cure, since we're assisting in preventing the disease from occurring; otherwise if you get that disease, you would have to be submitted to treatment (which is why you take 10 days of antibiotics for a bacterial infection, but are not necessarily cured from getting said bacterial infection again.)

Today's drug research is still fairly young in its methods and not to mention its an ever changing battle because we deal with biology and with biology we have to remember everything evolves to be the fittest in society, including the disease itself (please note, I am using 'disease' as an all encompassing term here). Cancer is difficult to find effective treatments because we are looking at it from a genetic level and everyone's biology is different. Then we also have mental illness which is taboo in our society so finding effective treatments is beyond just a biological level, its also the funding at the research level too. Drug research also takes a minimum of ~7 years before it even reaches human trials. This includes just getting the ok from a peer review board to conduct the research and having to get the ok from the FDA, its a long, long grueling process; and most of the time, in this research, it doesn't even get to human trials. Lets also not forget how freaking expensive it is to do drug research.

The side effect for all drugs allowed by consumer use is death, even those two Tylenol you take for your pain (which doesn't cure, it treats), has the side effect of death. If there are too many side effects for a drug, where its worse to take the drug than actually live with the disease, it is rejected by the FDA. I also would like to mention that regardless if the side effect is caused by the drug or not, it is included on the list of side effects. Someone could come in, help with the trial and reports that they got liver cancer from it...though it probably wasn't from the drug, it still has to be included on the list. In research we also call these outliers, but they still have to recognized in research. This is something to keep in mind though about side effects and remember its the researches who report this and up to the boards to decide to put it out on the market, not the economists.

So why do we have side effects? We are actually not that advanced in medicine yet and we are still pretty much treating the body as a whole rather than its individual parts. An example I like to use is putting motor oil into your vehicle; in order for it to run great you need to add oil in the right part. Making this super simple here..but if we look at our bodies like a car's engine and oil as the medicines, basically we just pour the oil all over the engine, hoping some will get to the right spot, this is where we are in medicine. This is why we have side effects because clearly oil doesn't need to go in the coolant or the windshield wiper fluid, but it does and its not going to react well; just like when we take medicine, its affecting our body as a whole and not its individual parts. Once we're able to effectively treat individual parts, I will be giving a whole different conversation here.

Sometimes extra drugs are prescribed to combat some nasty side effects, since sometimes there just is no other medication on the market for some diseases and there are some people out there who need it and can't function in society without it. However, if people are having side effects that are impacting their livelihoods, they don't have to live with it. Generally there are multiple medications on the market and one may work better than the other, which is why (and often costly, I do understand that) you have to communicate with your doctor about what is wrong.

So...this is not denying that when drugs that are successful and with minimal side effects do come out there is a nice price tag, and not denying either that there are some out there who are greedy bastards, but a lot of the side effects and drug creation is not an inside job. And to be honest, I would rather work for a pharmaceutical company rather than have my own private practice due to the insurance companies having way too much say how much time you spend with your clients.

This is good. Really good. I much prefer this way of thinking to the whole "companies are bad and they want us to be sick because it makes them more money."

Now making my own point:

Like GABA said above medicine is still something humanity struggles with. As far as "curing" things and treating illnesses. Now, in my opinion, I believe the best way to find cures and better methods of treating illnesses is to open the market up for competition to take place. If companies are competing this would provide incentive for said companies to provide good long term success in treating illnesses.

I also believe that with competition companies will actually compete to lower their prices for medicines and treatments. Thus helping the people with little to no money to pay for their medicine.

Capitalism it works.

 

[Dmitri]

This is good. Really good. I much prefer this way of thinking to the whole "companies are bad and they want us to be sick because it makes them more money."

Now making my own point:

Like GABA said above medicine is still something humanity struggles with. As far as "curing" things and treating illnesses. Now, in my opinion, I believe the best way to find cures and better methods of treating illnesses is to open the market up for competition to take place. If companies are competing this would provide incentive for said companies to provide good long term success in treating illnesses.

I also believe that with competition companies will actually compete to lower their prices for medicines and treatments. Thus helping the people with little to no money to pay for their medicine.

Capitalism it works.

To a degree. Competition helps a little bit, but not always in large scales (and that's not even taking into account the periodic monopolies in capitalism, such as diamonds which are mainly worthless but the prices are kept in such a high price because a single entity controls most of the supply and keeps the flow small in order to jack prices for a stone that's basically worthless and only desired because corporations brainwashed society into thinking that if you don't get her a diamond ring, you can't possibly love her). If competition really lowered prices to managable prices, how come insurance was not more affordable before Obamacare? Why isn't gas still less than a dollar? Why isn't food (especially healthy food) cheaper? Why won't Brandon pay the admins minimum wage? It comes down to profits. Milk consumers for as much as they can. You have to remember that insurance companies need to make money, so they need premiums to cost more than what they're dishing out to pay for stuff that insurance costs. So capitalism isn't going to solve it all.

 

[FinnSimmons]

I might be the eternal realist, but i just don't think that in upper management you can retain your humanity. Your goal is to make as much money as possible no matter how, to please shareholders and get the biggest bonus possible. Now that goes for pharmaceutical companies and other positions of power alike. You need to appease certain people or you eventually get replaced. Does that mean that every medicine is developed in a way to have side effects? No, but it surely makes it somewhat less interesting to improve upon existing drugs and treatments. It is not a priority. They will not 'waste' profits on it. Because in the end it it would only hurt themselves.
Smarter just to buy up patents in bulk or blanket patent things that dont even have medical application yet. Like they tried with human genome patents. Thankfully that was shut down in the US.
I'm just saying; we are not much different than the men and woman that lived in caves 50 thousand years ago. Don't make humans out to be so moral and good.

 

[Andrewza]

Americas sytem is flawed. Is it the worst? No but can it be better? Hell yeah.

Firstly south Africa uses a mixed privat and public system. Private hospitals are used by middile income and up where the poor use public.

Public hospitals get 40% of the funding private get and see 80%of patients. So of course privat means faster and better care. But hey if you got illnesses would you rather get no care or slow care.

South Africa spends 11% of it's budget on health care and some drugs like TB meds and HIV/AIDS meds are free. In America some dick hicked the price up by a few hundred percent.



Of course me personally. I have 100% coverage for live. And military hospitals are like a strange mix between private and public sector.




Obama care failed due to concessions forced on it. Not because it is a bad idea.

 

[Mr.BossMan]

To a degree. Competition helps a little bit, but not always in large scales (and that's not even taking into account the periodic monopolies in capitalism, such as diamonds which are mainly worthless but the prices are kept in such a high price because a single entity controls most of the supply and keeps the flow small in order to jack prices for a stone that's basically worthless and only desired because corporations brainwashed society into thinking that if you don't get her a diamond ring, you can't possibly love her). If competition really lowered prices to managable prices, how come insurance was not more affordable before Obamacare? Why isn't gas still less than a dollar? Why isn't food (especially healthy food) cheaper? Why won't Brandon pay the admins minimum wage? It comes down to profits. Milk consumers for as much as they can. You have to remember that insurance companies need to make money, so they need premiums to cost more than what they're dishing out to pay for stuff that insurance costs. So capitalism isn't going to solve it all.

Fair enough.

I might be the eternal realist, but i just don't think that in upper management you can retain your humanity. Your goal is to make as much money as possible no matter how, to please shareholders and get the biggest bonus possible. Now that goes for pharmaceutical companies and other positions of power alike. You need to appease certain people or you eventually get replaced. Does that mean that every medicine is developed in a way to have side effects? No, but it surely makes it somewhat less interesting to improve upon existing drugs and treatments. It is not a priority. They will not 'waste' profits on it. Because in the end it it would only hurt themselves.
Smarter just to buy up patents in bulk or blanket patent things that dont even have medical application yet. Like they tried with human genome patents. Thankfully that was shut down in the US.
I'm just saying; we are not much different than the men and woman that lived in caves 50 thousand years ago. Don't make humans out to be so moral and good.

I'd challenge you to not make them seem so inherently evil.

When push comes to shove humanity is rather good.
Or well that's what I believe.

 

[Lord Potatoe]

Well, technically, most drugs are made for one thing but are more effective at something else, so they market the side effect as the main treatment. Take Viagra for example, it was originally a blood pressure pill and look at it now.

 

[Clayton]

I'd challenge you to not make them seem so inherently evil.

When push comes to shove humanity is rather good.
Or well that's what I believe.

It's hard to do that when we have people like Martin Shkreli (granted, that price hike would not have translated to the consumer, only the insurance, and that particular medication was treating only a very small subset of the AIDS affected population) but... "oh the insurance can eat a 500% price hike" doesn't make it right.

Same thing with the EpiPen. I'd bet dollars to donuts the materials cost is $25 or less. Yet after each competitor in the business was forced out, the price hiked. You went from a $100 product you have to buy every year or two to a $600 product. A vial of epinephrine on its own is $5. You can't argue that it was to offset R&D of the EpiPen because that was publicly funded.

 

[Brandon Rhea]

I wouldn't say it's inherently evil either, but I do think it's important to keep this perspective: the primary motivating factor of an insurance company is not to provide you with health care coverage, nor is the primary motivating factor of a pharmaceutical company to create life-saving drugs. The primary motivating factor of any corporation is to make money. To do that they need a business model, and that's where insurance coverage and drug treatment comes in, but ultimately the role of those corporate executives is to provide the greatest value possible to their shareholders. That's why the for-profit health care system is fundamentally broken, because they are not in it for you and me. They are in it for profits. Most of the time they will be able to deliver coverage (to those who afford it), but it's not a system designed to care for all people.

In fairness, that's what a company is supposed to do. If executives were not providing the greatest possible value to their shareholders, they would be bad at their jobs. So that just means we should be looking at alternatives to this particular model.

 

[Clayton]

It should be pointed out that medical insurance practices have improved a lot since Obamacare. Caps on their profits have been put in place (any "profit" exceeding that gets kicked back to the public as dividends), and some very shady policies were outlawed, such as having a renewable contract where after a certain number of years your policy expires and you get an identical one from the same company but then under the new policy anything you were already treating gets labeled as a pre-existing condition and is denied. Shitty, shitty practice but for some people those kinds of policies are all they could afford.

But on the whole? Instead of being a gauze wrap like it was intended, all the concessions they had to make to get it passed effectively turned Obamacare into a bandaid over a gaping wound.

 

[Brandon Rhea]

Yeah, once they decided to try to regulate and build upon the existing model, any hope of truly meaningful reform went out the window. Which isn't to discount the meaningful impact it has had for a lot of people, since there are now millions of people who finally have insurance coverage, but it's still just a band aid like Clayton said.

I preferred the original approach, was to have a public option. The private market would have stayed basically as-is, but people could buy into government insurance if they wanted. The public and private options would then compete side by side. Ultimately people likely would have bought into the public option en masse, and it would have led to universal health care. What the president should have done, in my opinion, is propose single payer health care. That would then have made the public option the compromise. Instead, public option was the preference and the individual mandate became the compromise.

The one big, long-term upside to what's in the Affordable Care Act now is the provision that says insurance companies have to spend something like 80% of their money on insurance coverage. That leaves only 20% for overhead and profit. That's unsustainable. It's a very deliberately-placed ticking time bomb that could ultimately destroy the private insurance market and force the adoption of public healthcare.

 

[Mr.BossMan]

Well, I will have to say that I actually do agree with the both of you on this.
@Clayton @Brandon Rhea

 

[Dawyn]

Welp, the system is well and truly fucked at the moment. My father is a lawyer and our family health premiums just went from $600/month to $1,600/month and my father's firm is now paying $4,000/month per employee. In total $70,000/year in premiums alone for a family of five. Not to mention living in CA means we're subjected to a higher state income tax as well and he's paid more just for the cost of living, which means we take a harder hit in federal taxes. It's stupid now, we supposedly live in a capitalist society but now we're literally going to be paying more for all this than living in an actual socialist country with very few/none of the benefits those offer. I swear, you're going to see members of the upper middle class like doctors, lawyers, and businessmen start shooting up health insurance companies and/or government buildings if this continues.