Nationalized health care would just shift the expenses and creates a whole new set of problems.

Although Joe the mechanic at the dealership or Bob the service desk maanger don't have it coming, that's life.

I shouldn't have it coming that my taxes are going to bail them out.

Do people really think that the Big 3 will just shut down? Or do you see them filing for Chapter 11 instead?

Actually nationalised health care would largely REMOVE a lot of the expenses.

The European system of nationalised health care would provide adequate health care for the entire population of America (unemployed, elderly, young everyone) for what the country is currently paying for its private system. Thats WITHOUT contributing any more money that is presently being done (ie. America is currently heavily overpaying for the health service they have - despite you not having what I'd consider 'basic' services like being able to call a doctor out to your house to see your son when he's ill etc.).

The privatised American Health Care system is a joke from what I've seen of it, its incredibly inefficient and setup purely as a fiscal enterprice to make money.

Whenever you see a doctor you're encouraged to take numerous tests which are worthless at best and at worst harmful, sprained an ankle ... feel sick there are dozens of tests we can run just in case, bah humbug.

(sorry but while its not 'my' money paying for the individual tests - in the long run that bumps up the insurance and thus eventually that money does come from average joes - in the form of the companies paying for the cover having fewer workers)

PS - Sorry if that comes across as vehement but its been one of the biggest differences I've seen since moving over here, I was shocked that a country which considers itself a world leader has such a poor setup).

The United States already spends more money per capita on health care (including as % of GDP) than any other country.

What's needed is reform, not just "nationalization". The United States government can't possibly run something on this kind of scale well. Full nationalization would be a disaster on the scale of Freddie Mac/The Tax Code/The Military, etc.

Marc, the thing that I keep going back to is quality. We have most of the world's leading specialists and people come from all over the world to some of our specialists and clinics. I fully know very well about add-on costs (e.g., when my wife had her surgery this summer, I got bills from seven different entities) and the need to many tests (shouldn't we look at why doctors need to do so much to cover their butts?).

But it's like the adage: service, quality, price - choose 2 of 3 (or something like that). I, for one, would not suffer quality when it comes to specialized care. There is already an acute shortage of certain specialists in this country (like ob-gyn doctors) because of external forces driving them away. Like in most professions, there is the incentive to excel (re: $$$) and to be the best, adding the factor that many put a high value of health regardless of cost.

I do not my private health care to change, I have been extremely happy with the quality of service I and my family have received over the years. Let's work on getting coverage to those that need it but don't provide a one-size-fits-all solution to those that value quality over price.

Not to mention turning private professionals into bureaucratic-laden government workers. That's probably alright for some professions, but not for something important like our individual health.

If Walmart gets a better deal from suppliers because it is so large, why wouldn't nationalized health care, with such a massive customer base, not be able to strongarm better prices?

After being opposed to it for years, while watching insurance companies make profits while raising rates and reducing benefits, I am left wondering why letting more people into a nationalized health insurance system would be bad for anyone other than the providers (who would naturally be forced into reduced "contract prices" for those people, just the same as Walmart suppliers end up doing that as well).

As far as the Big Three goes, they can go under. If they had rolled into DC saying they needed this capital injection because they were not going to make any purely-gasoline fueled vehicles in the future and needed help transitioning all of their production facilities to make hybrids, electric vehicles, and other alternative energy vehicles, I would be more inclined to green light it. Instead, they came in and pretty much want to keep business as usual. No dice, guys. Enjoy the flight back on your posh corporate jet. The next time you want to beg for money, you should fly coach/economy class, rent a small car and drive yourself to the hearing, bringing a commitment to reduce your salary and a "paradigm changing plan." Everyone is quick to blame the UAW for the woes of the Big Three, but upper management is ALSO compensated at much higher levels than their competition. If there is a problem there with compensation, it starts at the top.

If the government could run healtcare as well as Walmart runs its business, I'd be all for it.

If all they have to do is negotiate "contract fees" like the other insurance companies, I don't see the problem. Why wouldn't they be able to negotiate great rates with the providers? If the choice is getting paid these contract prices for providing care to a group that is otherwise uninsured (and subsequently would likely default on their uninsured charges anyway (which tend to be larger than insured rates)), why wouldn't they choose something over nothing?

If they can keep the lobbyists out of the system, it could work.

I guess the same reason the military can't negotiate "great rates" for military contracts. Maybe Haliburton gets into the medical care game.

It is because they don't want to. The DOD process is highly flawed and is not even a reasonable comparison. I'm not talking about putting the "healthcare for the nation" out as a contract bid. I am talking about a system that negotiates fees for products and services just like a private provider does, but as a non-profit entity.

If it was ran just like any other insurance company on that side of the business, where is the problem?

The idea is to use the existing healthcare the Feds already have and open it for everyone. I think they have a pretty good package, and with even more buying power could probably get even better. The question is implementation, of course.

The problem if they contract out healthcare, I can see crap "professionals" become providers because the government would give out contracts to minority businesses as part of quotas.

We lost a contract to an Alaskan Native American owned company and they hired all of our instructors. The government is paying them 150% of what they were paying us for the same product. As a taxpayer, it just doesn't make any sense.

Ok. So the fear is that the only hospital that those with the government plan would be able to go to is the one owned and operated by minorities? That the only doctors you will be able to see are minorities? Sounds like Aetna to me. Seems like a majority of the medical professionals on any plan I've had over the past several years have not been white (or even male, so they're already predominantly minority without a government plan...).

Actually, that is a symptom of one of the many problems with our current system. Many, many primary care doctors are coming from over-seas, because home grown doctors are going to specialties because that is where the money is. Same with Ob-Gyn's.

FWIW - my experience as an immigrant from the UK is pretty much exactly the same as Marc's. The NHS isn't perfect but it's a hell of a lot better than the situation I am in right now (and I have the money to pay for a decent health plan)

A guy at work has been forced by his health plan to take an MRI and some other ridiculously expensive test for knee pain, and all the guy wants is some painkillers. It's a crazy system where the people that are providing the care have absolutely no incentive to keep costs down.

To clarify, it is not the fear that a hospital will be owned and operated by minorities, but it will be owned and operated by personnel who are not the most competent.

Oh. And that the government will only negotiate network services with those entities? Are you sure these incompetent medical professionals will setup shop in every community of the nation? You do realize they won't be able to force everybody to go to "Quack Doctors 'R Us" in backwoods Alaska, right?

Im confused, some on here were saying the TARP was a bad thing cuz the govt would botch it. They then didnt spend the monoey which should please those against the TARP to begin with thereby giving credit where it's due but I havnt heard anything of the sort. Now I know that isn't necessarily what we're talking about now but, IMO, they botched the TARP but 'saying' theyre not going to buy the bad assets so why arent the opponents of it giving Paulson credit and thereby earning some, even a tiny bit of credibility for other govt run systems going forward?

I never said the government will ONLY negotiate with these entities. Furthermore, I never said they were incompetent.

Marc, I've never experienced any of the issues you just described.

If I'm sick enough, I go to Urgent Care, I see a doctor, they may or may not prescribe something, but, I can't ever remember having any extra tests or anything like that.

Even when I've had more serious issues (kidney stones, busted knee, dislocated shoulder...) I had nothing but good service. I've had several different health care providers and the only issues I've ever had are with billing.

There's horror stories regardless of what system is being used and I'd like to say you get what you pay for, but, I don't think that's the case. I pay about 100 a month for my insurance, 10 dollar co-pay for doctor's visits and presriptions.

I'm sorry that you've had nothing but horrible experiences with our health care system here.

You have your own insurance for $100 a month w/ $10 dollar co-pays? What is your deductible? Who is the provider?

Or is this through an employer that is picking up the rest of your premium?

The five years I spent as a student in the UK made me realize what a huge clusterfuck American health care is, and I've always been able to afford good health care in the U.S.


What percentage of Americans do you think are able to afford these specialists, Bucc? Even those who have good health care? You're also talking about a very small percentage of cases that need these specialists, in fact, I'd bet the number of Americans going abroad to places like India to save money on routine surgeries (yes, it happens) is actually larger than the number of people coming to America to see specialists (or at least close).

Furthermore, where do you think most of these specialists are? They're at institutions affiliated with hospitals or universities, not at insurance companies. And how are these institutions funded? By the government and by private donations (quite a bit of the latter, in many cases). These specialists aren't going to go away if the health care system changes.


Well, I hope you don't have an HMO, then, because if you do, it's unlikely to be your choice, in the end. In fact, it's likely to be the choice of some bureaucrat at the insurance company. Heck, even if you have a PPO, your insurance company may decide you don't need to see a specific specialist, and refuse to pay, or refuse to pay in full.


Most health insurance in the U.S. is already run by massive bureaucracies. They're just called Blue Cross Blue Shield, Humana, Guardian, etc... instead of the U.S. Government. Don't kid yourself here.

Any of whom I trust (as little though that may be) exponentially more to get something right than I do the U.S. Government (or any state/local government for that matter).

If you look around the world a lot of countries have 'leading specialists' in various areas - land mass/population-wise its not particularly surprising that America has a lot of 'leading specialists' really to be honest.

One of the reasons I lived near Cambridge when I was in England is that Addenbrookes hospital which is world reknowned for its maternity/child surgery side of things.

But surely thats an aside - in England we have a nationalised health system BUT you can take up private health care if you want to yourself ....

The difference is that the private health care is dirt cheap because they know most people will still use the NHS for minor ailments and so while they're covered under private cover the actual cost to the customer is far cheaper than in America (for instance the cover here for my family if I wasn't covered by work is a princely $1800/month (shocked the heck out of me, although I do have a family of 5) - back home it was about £80/month for better cover privately - ie. less in the way of excess charges and much higher caps on dental work etc. - oh and don't get me started on Opticians bills, put it this way I wait to see an optician until I travel back to the UK where the eyesight test is FREE rather than $100+).

The amount of bureaucratic stuff in the health system over here is unbelievable compared to the UK to be honest, back home you go in - see someone, get given a prescription and thats it (I can't ever recall being asked for ID come to think of it apart from when you initially sign up to the practice, but then who'd want to fake being me and besides generally they roughly 'know' their patients as you stay with the same doctor for years).

Over here you fill out a form, see someone, give id, fill out a few more forms and ... then you get a prescription. But wait we're not finished several weeks later I'll get sent a stack of paperwork to file from the Health insurance company and also from the company who ran tests/whatever .... all of this 'bumpf' has to be paid for and is ultimately increasing the cost of medical coverage.

I'd expect its a company provided scheme like the one I'm on - I think I pay a similar amount, however because I moved 'divisions' within SEGA I know how much it'd cost to continue that cover outside of the company (for some legal reason they had to switch the cover when they switched departments which lead to the company involved sending a letter offering to allow me to continue the coverage ... presumably by selling my house to gover the first months charge ;) ).

As an aside Jedi - do you have kids and/or a wife? .. as I'm lucky enough to be generally fairly healthy and so for me the American system would be fine, its my missus and kids who cost a fortune under the American system, kids pick up illnesses from school all the time which you feel obliged to get checked by a doctor just in case and having had kids has left my wife with weak enamel on her teeth (and every filling or whatever has a deductable on it, yay ;) ).

Wow, I'm amazed at some of the health care experiences you guys are having. I have BC/BS of Illinois, have been put on numerous trial drugs for my illness, seen numerous specialists, and currently have a nurse coming to my home from an hour and a half away twice a month to simply give me a shot and I have never had to fill out any paperwork nor have I ever had to pay more than co-pay ($20 for office visits, $10 for 3 month supplies of most of my meds, and $75 for a $8800 shot that I take). I enjoy our current health care system, always have, particularly after hearing how many problems several of my British friends had in England with their system.

The big difference is that most defense contracts don't have other purchasers. With healthcare, there are numerous entities around the globe paying for services. The best way to deal with prices IMO is to demand that the government get the lowest available price. Big corporations already demand this, but the government has allowed companies to charge excessive prices.

Is very possibly partially a regional thing - especially with a country the size of America standards and service can vary hugely (its similar back home there are 'problem' NHS areas, particularly in some regions of larger cities).

As with most things in life I think you tend to associate your own experiences with whether something is 'good/bad' in life - for instance I love my Chysler Aspen, its the right size for me and has never had anything wrong with it since I've got it ... but I've spoken to people who've had real hassles with their ones. Now I'd buy one again without a second thought, but if it'd had serious mechanical issues with it continually like some of the people I've spoken to I'd have branded it a bad vehicle and never had one again.

(so in essence I don't think there's a right or wrong perspective as far as is the UK or American setup better worse as far as providing care, I'm sure there is good and bad coverage in both systems .... I prefer the UK one because I've always thought providing free health coverage to all people is something that should be a 'right' - but then again I've been brought up with that mentality because of where I was born and raised).

That could be true Marc, I hadn't considered that.

I just see a lot of problems with our health care from all aspects.

1) A deeper, broader pool of state-of-the-art technology, specialists, and hospitals. All that costs more. If you want the best, you got pay for it. Throw in the high costs of schools (8-9 years-Undergraduate and Med school) and a rather low wage during your residency, doctors aren't making real money until they hit their mid-to-late 30s/even 40's.

2) A lack of malpractice protection for doctors. I think one of the major problems that doctors/surgeons subscribe so many tests, drugs, and treatments is to prevent themselves from getting sued. Face us, Americans (in general) are lawsuit, get-rich-quick, happy. When doctors are paying six-figures just for insurance, we have a problem. The UK (not sure on other countries) has a very strong system in preventing this (if you lose a civil case, you have to pay, correct?).

3) I believe doctors/surgeons are losing money now on to see patients on Medicare/Medicaid. That is why you are having a major problem coming with doctors/specialists not accepting it. When they do, they have to make up those costs elsewheres.

4) Patients-As noted in my first paragraph, I think doctors have lost control to demanding patients who want the best, all the tests, are lawsuit-happy, but want someone else to pay for it. Everyone wants to lastest $200-a-pill drug or the lastest treatment that just came out, but they won't pay for it. A MRI machine alone costs around a million bucks. Doctors need to be given back control. Also, we need to start taking care of ourselves better. If a smoker gets lung cancer, should taxpayers really be responsible to pay for the very expensive care they'll get due to their poor actions?

5) Insurance companies, paperwork, and high overhead costs. Insurance companies are telling doctors what they need to do, what they can't do, and what they will pay. They have to fill out so much paperwork that requires a high overhead cost, they are having trouble.


A universal health care system is useless if you don't fix the problems. I also would hate the idea of a system like Canada which outlaws practice, non-governmental practices. If a skilled surgeon wants to be a private practice, then he should.

Bush says Citigroup deal needed to protect system - Yahoo! News
Fratto said companies like Citigroup are so "systemically large" that they could "bring down not just the entire U.S. financial system but the global financial system."

So, yeah, Citigroup is being bailed out, under the guise of "too big to fail". It's time to bring a big trust busting stick out on all of these companies

SI

Check this out:

"Hill City, Lakota - November 24, 2008 - In a stunning development, the Free & Independent People of Lakota announced today the introduction of the world's first non-reserve, non-fractional bank that accepts only silver and gold currencies for deposit. Indian Tribe N. Dakota> http://press.freelakotabank.com/


Welcome to Free Lakota Bank The Free Lakota Bank is the world's first non-reserve, non-fractional bank that issues, accepts for deposit, and circulates REAL money...silver and gold. All of our deposits are liquid, meaning they can be withdrawn at any time in minted rounds.

"Money is the barometer of a society's virtue. When you see that trading is done, not by consent, but by compulsion...when you see that in order to produce, you need to obtain permission from men who produce nothing...when you see your laws don't protect you against them, but protect them against you...when you see corruption being rewarded and honesty becoming a self-sacrifice...you may know that your society is doomed.''
At the Free Lakota Bank, we issue, circulate and accept for deposit only AOCS-Approved silver and gold currencies. Silver & gold are a store of value, an equivalent of wealth produced. Paper is a mortgage on wealth that does not exist, backed by a gun aimed at those who are expected to produce it. Since we deal only in real money, we do not participate in any central bank looting schemes.

Money is made possible only by those who produce. Paper is not money, instead merely a promise to pay. We hope that some day the rest of the world will awaken from the American Dream: the dream that a person can sustain life by consuming more than producing. We call it the American Dream because you must be asleep to believe it. Well, that dream now has a silver lining; as people discover the dream is really a nightmare, the only solution is a return to value: value that comes from production and honest trade."

I got a quarter that says something in the Lakota press release is illegal.

Use of the term 'too big to fail' is becoming too big too fail, it must now be applied to all situations.

In other news, yay for shorting Citigroup a few months ago, 4 times return after the cover. Wondering if I'm ever gonna run out of banks to short at this rate. Bah humbug bailouts and mega mergers, killing the economy slowly.

"If you had any doubt at all about the primacy of Wall Street over Main Street; the utter lack of transparency behind the biggest government giveaway in history to financial executives, and their shareholders, directors, and creditors; and the intimate connections the lie between Administrations — both Republican and Democratic — and the heavyweights on Wall Street, your doubts should be laid to rest. Today it was decided the government will guarantee more than $300 billion of troubled mortgages and other assets of Citigroup under a federal plan to stabilize the lender after its stock fell 60 percent last week. The company will also will get a $20 billion cash infusion from the Treasury Department, adding to the $25 billion the bank received last month under the Troubled Asset Relief Program.


This is not a particularly good deal for American taxpayers, but it is a marvelous deal for Citi. In return for all the cash and guarantees they are giving away, taxpayers will get only $27 billion of preferred shares paying an 8 percent dividend. No other strings are attached. The senior executives of Citi, including those who have served at the highest levels in the US government, have done their jobs exceedingly well. The American public, including the media, have not the slightest clue what just happened."


link

This is something I find interesting - do insurance companies charge considerably more to smokers in America?

In England the goverment gets around this due to the huge tax on smoking (packets of cigarettes are in excess of £5 ($8) for 20 smokes of which something like £3-4 is tax I believe).

I remember watching a debate on smokers and the NHS and actually the tax from smoking in England more than covers the costs of medical care for their illnesses.

Do a majority of private and public employees (at least working for a non-small business) get covered by plans where the employers pick up most of the premiums? I have never belonged to an HMO or have had to go through a government program like VA or Medicare. It's always been an EPO for me and my family. That was my point about specialists. I have the same deductable whether I go to my family doctor once a week or to a specialist. The only thing that's not covered by the 85% rule is MRI. The experience that I have had was that regardless if I had a $60,000 surgery like I had in 2004 or my wife's surgery this summer or simply office visits, the administrator of our plan (the plan was locally-owned/participated and not one of the big bureaucracies) lowers the billed fees by half and then pays for 85%, minus the $20-25 copay. I have not been turned down for any specialists we have seen (about 8-10 different ones over the years).

Apparently, in preparation for their big bailout from the taxpayers of America, my wife received a letter informing her that her interest rate on our lone Citibank credit card was going to 17.99% for new purchases. This has nothing to do with late payments (which never happened), or a credit score issue (her score is 815 as of this past July). Upon being called, they admit as much, and basically say they are doubling it because they can and she can choose to not accept the change and they will close the account when the card expires.

If they are treating excellent credit risks this way, just what business are they intending to be in?

Citibank is the worst company in the world. I never once missed a credit card payment and they raised my interest rate to 29.9% based upon my credit report. I canceled my account the day I found out they raised it and will never deal with them again.

I think the reason for banks raising their rates is simple.

* America has a cosy cartel of banks within it (no foreign institutions are allowed).
* The number of banks in this cartel has dropped with the mergers leading to less competition and easier price fixing between the few remaining.

Simple as that really, they don't care if they lose sensible customers - they're after the ones with balances who'll pay interest - thats where their profit is.

If America opened up the country to foreign banks then instantly you'd have a MUCH more customer orientated system which would provide a much better and more competitive service for people.

Apart from the health care the main thing I miss about England on the 'financial' front is the banking system back home - NO bank charges, a grace £50 overdraft limit at most banks (within which the bank consider it a minor mistake on your behalf no letters or hassle), banks being happy to give you a resonable over-draft facility and work with you if you anticipate a hard patch coming up (I've done this a few times in the past myself back home - the banks actually reward sensible planning heaven forbid ;)), a DECENT level of interest on savings (normally between 5 and 8% depending on the account at present) finaly a sensible setup where if you try to use your card without funds in the account it bounces the card usage rather than putting it through.

So now we are facing a future with a banking system that attempts to get over on all their personal banking (and small business) customers. A banking system composed of a handful of banks, with all the mega-consolidation driven by the hands of government.

So, once again, we pay for it on one end with our own money saving these terrible businesses, and we pay for it on the other end with more draconian policies and fees. I'd still like to know why this is really better for the individuals of this nation. As each new bailout happens, this seems much worse for the average individual than it was the day before.

Looks like the National Insurance premiums and taxes in Britain are going to see a big increase. That's a shame because it's only going to make the economic situation worse than it already is in that region.

Pre-Budget report: National Insurance rise adds to high earners' woes - Telegraph

If the American goverment were brave enough to open up your banking to foreign banks then it'd have a huge positive effect on things for the consumer imho.

(The reason banks are competitive in the UK is simply that there are lots of them and only the decent ones survive, others lose customers and get bought up by the larger banks. A UK bank wouldn't get off the ground if they tried to put in place American banking style charges - simply put no one would stand for it.)

The old 'reasoning' for only having American banks from what I understand was a fear of relying upon foreign institutions for assets - but seeing as most of the American banks are heavily owned by the middle east these days I don't really think thats a huge issue now ;)

Its swings and roundabouts - they've also cut the level of VAT by 2.5% which effectively balances things for high earners and ensures that low wage earners end up better off (as they're the ones worst hit by the recession).

To be honest the UK has always had a high income tax rate compared to America - thats the price you pay for the facilities provided for society (ie. nationalised health care, social security etc.) .... also take into account the levels at which they kick in - if you earn £150,000 ($225,000) then to be honest paying a little extra in national insurance tax isn't going to kill you imho (especially when you're getting an extra 2.5% for your money via. the VAT cut).

PS - Yes I know I always come across in support of England, can't help it ... natural bias :D

One problem with the UK adding this new tax rate. They'll just drive even more of these high tax earners, and businesses, to tax-friendly countries like Switzerland, Monaco, Singapore, or the United Arab Emirates (Dubai). Unlike the US where citizens are tax on their global income regardless of where they like, Britain doesn't have this.

Interesting news is the battle between the US government/IRS and UBS.

I wonder if US government will win? http://www.guardian.co.uk/business/2...bs-switzerland

Also, I'm guessing the Swiss government will be aggressive in protecting its laws.

The Wiki disagrees, see below. I don't know if there is a list of banks per capita by country or something like that. I really don't think the UK has more banking options than the US. It seems like HSBC and Barclays issue about every credit card in the UK. I don't know enough about consumer services offered by the banks in the UK, but I can vouch for getting pretty much free banking (checking account) everywhere I have lived in the US.

If you live in the US and you are paying a bunch of banking fees, you are not looking very hard.


List of banks in the United Kingdom - Wikipedia, the free encyclopedia