So... is your hypothesis that there are a bunch of unemployed Doctors in urban areas? If you move resources out to rural areas they have to come from somewhere. Assuming that those resources were being used, that leaves other resources strained or people un-served. As a country I don't think we have enough qualified medical professionals to serve everyone even if we could somehow magically give everyone enough money to afford care.
Nope, that's not what I'm saying at all. Let me keep this simple to begin with, and if you want clarification or me to expound on one of the points I'm about to raise, I'll do so.
Physicians are not cogs to be inserted or removed into a healthcare 'machine'. Healthcare isn't a simple system, and thinking of it in simple terms like that misses the realities of how healthcare works.
I'm pretty sure I explicitly stated that physicians aren't the be all, end all of healthcare delivery. We could easily start to address some of the gap with PAs, NPs, and even Paramedics.
You're also operating in the framework that our current healthcare system is free market, or that our current system of delivery is the only way healthcare can be delivered, neither of which is true.
There is a glut of physicians in Urban Areas and they're poorly utilized. The issue isn't that there aren't enough physicians, it's that the way the US uses physicians is inefficient. Part of this is due to a never-ending turf war between Physicians, Nurses and PAs.
We've got a glut of specialists and not enough PCPs, who could easily do a lot of the common procedures that specialists do (for instance: Botox injections). We've overspecialized because specialization is where the money is.
There are well more medical school graduates looking to work in the US than there are Residency positions in the US. A lot of people who could be adequate PCPs end up going into research or changing fields entirely because they can't find a residency, and they can't practice in the US without doing a residency program.
Every sector of our healthcare industry right now is inefficient. The majority of EMS systems in our country are based on the fire department model, and although high-performance systems have existed for years, it would require the Fire Service to lose the EMS cash cow in order to produce.
Telemedicine can create a huge boon for healthcare, there is no reason a doctor in New Mexico can't video conference in a specialist from Maine to see and speak to a patient. But right now our healthcare system is fractured state by state, which poses major barriers to doing something like that.
In many rural and underserved areas, EMS units could be utilized to provide basic preventive care (like giving vaccinations), which would reduce the need for a physician to handle routine preventive care tasks.
And those are just the examples I can think of off the top of my head.
Seriously, though, IHS (Indian Health Services) could be a model. The big problems with IHS (besides an involuntary sterilization scandal in the 70s) all relate to underfunding.
Sure, if you want to go the single-provider route, the Public Health Service could be the model, but I wouldn't recommend it. IHS... has a lot of issues. The Navajo nation is moving towards a self-sufficiency model, where the Navajo staff many of the hospitals out there rather than IHS officers. There are other problems with this model, namely that it's a uniformed service and not something that would necessarily be applicable to the nation as a whole (in that I mean a lot of healthcare providers are NOT good candidates for that kind of structure).
I'm going to agree with magickware99 on this one. Can anyone point to a country with a population close to ours whose socialized health care system is a success story?
Brazil has been mentioned, I understand Japan also has universal healthcare and a population over 120 mil. I wonder what are your expectations here? What do you consider "a population close to ours" and "a success"? Brazil is #5 in the world in population, USA is #3, Japan is #10. Do you just assume that there's no way to make it work in the USA unless China, India, or Indonesia can first show you how it's done, and any successes in other countries in the world are irrelevant?
Or put it a different way, if the other largest population countries in the world don't have universal health care, and their systems also don't appear to be very good, how does that support the argument that more socialization of health care in the US would be a bad thing?
I'm for universal healthcare, however you have to be careful in country to country comparisons. All else removed, physician training isn't consistent between countries, nor are cultural norms or the public's view of healthcare. There are going to be pros and cons for every system out there, and the US has progressed so far down the private insurance road that you can't easily compare it to a countries that have had a universal system set up in a different environment.
Another thing- I don't consider health care to be a basic human right. Why should it be a basic human right?
What about infectious disease? Contagion could affect you as well. Or you could live on your own island. No doubt there are attempts to isolate the rich from climate change in an island off the coast of West Africa, one where, funnily enough, the entire concept has not been thought through.
I think there's fundamental confusion or disagreement about what it means for something to be a "basic human right." Just because you think it's smart to provide everyone with healthcare doesn't mean it's a human right. I'm sure some people will disagree with my definition, but I see "basic human right" as an entirely different thing from a policy decision.
A policy decision is something we do (or don't do) because we think it's the best idea under the circumstances. The pros outweigh the cons. We allow people to drive cars because we think the pros of people having the ability to drive around outweighs the cons (like pollution and accidents). If the government decided to outlaw private car ownership tomorrow, many people would argue that this is a dumb decision and would try to get the law changed back. But at the end of the day the right to car ownership isn't a basic human right and it's something that we as a society could decide to get rid of if we thought it made sense.
A basic human right is (in my mind) something that we consider to be so important that we don't even weigh the pros and cons. For example, in the US we say that the right to freedom of speech is a basic human right. Even though 99.9% of people hate the Westboro Baptist Church and think their message is terrible and damaging, we say "they have a right to free speech, it doesn't matter how horrible their message is" and we let them picket funerals.
So in this framework I agree with magicware99 that universal healthcare isn't a basic human right. The fact that people on both sides are debating the pros and cons and talking about feasibility means it's not being talked about like a basic human right. If healthcare was framed as a basic human right, then the rebuttal to arguments like "I don't think universal healthcare would work well in the US" would be "who cares whether it would work well, it's a right and we have to provide it to people no matter the cost."
I guess to me that is largely a separate but related issue... We have the discussion on inefficiencies in the current health care system and a discussion on how to "sell" or "distribute" health care. I was talking purely about distribution given the current inefficiencies. I don't know how feesable it would be to debate both at the same time as it would be quite complicated.
I will still contend that based on geography alone I am not sure that it's possible to provide every rural area with a relatively near by source of what most people would consider to be an acceptable minimum level of health care.
I do agree with you though that the inefficiencies in our health care system are a huge source of problems currently and for any changes. I think that would be a great place to make headway.
I guess to me that is largely a separate but related issue... We have the discussion on inefficiencies in the current health care system and a discussion on how to "sell" or "distribute" health care. I was talking purely about distribution given the current inefficiencies. I don't know how feesable it would be to debate both at the same time as it would be quite complicated.
I will still contend that based on geography alone I am not sure that it's possible to provide every rural area with a relatively near by source of what most people would consider to be an acceptable minimum level of health care.
I do agree with you though that the inefficiencies in our health care system are a huge source of problems currently and for any changes. I think that would be a great place to make headway.
Okay, well even assuming the current inefficiencies, it would be possible to provide better healthcare to underserved areas. Which isn't just rural, as an aside. There are many areas of cities that can be considered underserved, or specific populations in cities.
Everyone is always so hung up on solving the problem, they often missing that simply alleviating some of the problem is a good thing.
What about infectious disease? Contagion could affect you as well. Or you could live on your own island. No doubt there are attempts to isolate the rich from climate change in an island off the coast of West Africa, one where, funnily enough, the entire concept has not been thought through.
How exactly does the possibility of me dying to an infectious disease make me decide that health care should be a basic human right? Is the fear of death supposed to make me decide that healthcare should be a basic human right? How does that even work? All the healthcare in the world won't prevent me from actually dying sooner or later.
My definition of basic human right is roughly similar to bitterroot's. I define it as something that is fundamentally something we possess- the ability for action.
Practically speaking, I define it as the freedom to STRIVE for anything and everything we want. Note that I capitalized STRIVE for a reason; this is a huge difference from the commonplace definition today.
Brazil has been mentioned, I understand Japan also has universal healthcare and a population over 120 mil. I wonder what are your expectations here? What do you consider "a population close to ours" and "a success"? Brazil is #5 in the world in population, USA is #3, Japan is #10. Do you just assume that there's no way to make it work in the USA unless China, India, or Indonesia can first show you how it's done, and any successes in other countries in the world are irrelevant?
Or put it a different way, if the other largest population countries in the world don't have universal health care, and their systems also don't appear to be very good, how does that support the argument that more socialization of health care in the US would be a bad thing?
The point is that it is more proper to compare the U.S. to countries that have some similarity between the two. For example, it makes absolutely no sense whatsoever to look at the healthcare system in any of the Scandinavian countries and say we can adapt that system for the U.S. There are simply far too much of a difference between the U.S. and the Scandinavian countries.
A country with a population that is at least over a 100 million is more apt to face issues similar to those faced by the U.S., and so it is a good starting point to make comparisons.
Look at the Atlantic piece I posted earlier. The Brazilian health care, even though it's a national one, still works better for the rich and poorly for the poor. IIRC, the article outright says that the benefits of Brazilian healthcare comes more from different approaches to healthcare than the fact that they have a national one.
I guess to me that is largely a separate but related issue... We have the discussion on inefficiencies in the current health care system and a discussion on how to "sell" or "distribute" health care. I was talking purely about distribution given the current inefficiencies. I don't know how feesable it would be to debate both at the same time as it would be quite complicated.
I will still contend that based on geography alone I am not sure that it's possible to provide every rural area with a relatively near by source of what most people would consider to be an acceptable minimum level of health care.
I do agree with you though that the inefficiencies in our health care system are a huge source of problems currently and for any changes. I think that would be a great place to make headway.
Okay, well even assuming the current inefficiencies, it would be possible to provide better healthcare to underserved areas. Which isn't just rural, as an aside. There are many areas of cities that can be considered underserved, or specific populations in cities.
Everyone is always so hung up on solving the problem, they often missing that simply alleviating some of the problem is a good thing.
Certainly we could, but would it be better to do that by reducing inefficiencies in the care system itself or by changing the way care is distributed? I think reducing inefficiencies in the system would go a longer way than changes to distribution. Let's make the system work better before we worry about how to provide access to an inefficient system to more people.
Quick real world example of crazy health care inefficiency... My Grandfather was the administrator at a hospital and he retired about 15 years ago. While he was the administrator his salary never went into 6 figures.... I know that the current Administrator at that hospital makes something in the range of $300,000+. I also know that while her employees have been on a wage freeze for years her salary has steadily increased every year (and by steadily I mean 20%+ raises).
What about infectious disease? Contagion could affect you as well. Or you could live on your own island. No doubt there are attempts to isolate the rich from climate change in an island off the coast of West Africa, one where, funnily enough, the entire concept has not been thought through.
How exactly does the possibility of me dying to an infectious disease make me decide that health care should be a basic human right? Is the fear of death supposed to make me decide that healthcare should be a basic human right? How does that even work? All the healthcare in the world won't prevent me from actually dying sooner or later.
So, you're arguing your ideals against all rational argument? Interesting.
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Card advantage is not the same thing as card draw. Something for 2B cannot be strictly worse than something for BBB or 3BB. If you're taking out Swords to Plowshares for Plummet, you're a fool. Stop doing these things!
This whole argument for me, as a healthcare worker myself, is do you give a ***** about your fellow human beings?
If you do care about those who cannot afford healthcare, like the impoverished, disabled, mentally ill or those otherwise unable to afford a high cost medical insurance policy, then a socialist model that covers everyone is the only way to go.
Here where I live in Australia, we have Medicare > everyone who earns over a certain amount of cash annually, must pay the medicare levy through your tax to cover it.
The idea being, that ANYONE, ANYTIME can just walk into an emergency dept. and get 1st world-rate healthcare and get their needs attended to.
FOR FREE.
You walk out the door (if able) without spending a buck.
Of course there are holes in the system, like mental health for example (but I doubt any countries in the world actually tackle this well), but the premise remains that emergency healthcare is there for anyone who needs it. Other more long-term needs, like a chronic arthritic hip for example, will eventually get done, but of course the queue is a fair bit shorter if you're willing to front the cash or have private healthcare.
When you look at the stress on the Aussie national budget to provide such a service, it is large, but given the horror stories I've heard about the system in the USA (like insurer's who back out of helping cancer patients and refuse to honour their policy, forcing the patient to sell their house, or worse) I wouldn't want to go to a system like the one in the USA.
FYI;
Barrack Obama has been quoted a few times saying how he wanted a system similar to the one in Australia, so we must be doing something right....
Barrack Obama has been quoted a few times saying how he wanted a system similar to the one in Australia, so we must be doing something right....
I don't know much about Australian healthcare, but on a little bit of research it appears to be similar to the French system in that the government is a universal payer, is that correct?
It's not just an issue of efficiency by hospital. The market itself drives inefficiency. I was reading today about a Hepatitis C treatment that costs $82,000 over a year. It's over $1000 for a single pill. Because it's so prohibitively expensive, it led to rationing in the VA and prison system, which is where ironically the only people this medicine serves--the folks with socialized medicine. The company won't produce more because it would lead to the price going down. It's not an issue of the company recouping the costs, because they made back all the money they probably invested in the first quarter where this medicine was released--and I say probably because the costs of developing medicine and divulging that info is notoriously opaque and obfuscated.
This was also an issue with antiretroviral drugs in Africa.
How exactly does the possibility of me dying to an infectious disease make me decide that health care should be a basic human right? Is the fear of death supposed to make me decide that healthcare should be a basic human right? How does that even work? All the healthcare in the world won't prevent me from actually dying sooner or later.
My definition of basic human right is roughly similar to bitterroot's. I define it as something that is fundamentally something we possess- the ability for action.
Practically speaking, I define it as the freedom to STRIVE for anything and everything we want. Note that I capitalized STRIVE for a reason; this is a huge difference from the commonplace definition today.
The reason why you're not already dead from polio or some other childhood disease is because the government invested millions, if not billions of dollars on getting everyone vaccinated against common diseases that would kill people. Your beloved free market wouldn't do that because ongoing treatment for polio patients means more money in their pockets.
I'm interested in finding out if you pay your own health care premiums or if the government or your parents pay for your health care. Because it seems to me that instead of telling other people to strive for anything, you should pay your own way before telling other people to pull themselves up by their bootstraps. Monthly premiums at my old employer were $800 for Aetna HMO with a $7,000 deductible. That would eat up most everyone's paycheck except the ED and VP, who gave themselves raises each year.
The reason why you're not already dead from polio or some other childhood disease is because the government invested millions, if not billions of dollars on getting everyone vaccinated against common diseases that would kill people. Your beloved free market wouldn't do that because ongoing treatment for polio patients means more money in their pockets.
I don't love the free market. In fact I don't like it one bit.
And, yes, I would agree with you. Many of us would probably be dead from the terrible diseases that had essentially been eradicated in the U.S. through the vaccine programs.
How exactly does this make me think that healthcare is a basic human right though?
It is one thing to desire a certain something or an outcome, and quite another to call that something/outcome a "basic human right".
I'm interested in finding out if you pay your own health care premiums or if the government or your parents pay for your health care. Because it seems to me that instead of telling other people to strive for anything, you should pay your own way before telling other people to pull themselves up by their bootstraps. Monthly premiums at my old employer were $800 for Aetna HMO with a $7,000 deductible. That would eat up most everyone's paycheck except the ED and VP, who gave themselves raises each year.
I didn't tell people to "pull themselves up by their bootstraps". If that is what you took from the way I define basic human rights, then you're mistaken.
I'm saying that you should have the ability to affect whatever you want, within the constraints of the given law/rule of the time. And if you don't like the law/rules, then you're free to attempt to change the rules. Ideally through an existing method in the governmental framework, but that isn't always possible and so you'd probably have to resort to extralegal means in that case.
Anything that prevents you from attempting these things are a violation of your basic human right.
So if you want to have the government pay for everything you want, then you're perfectly free to attempt to get them to do that.
This is really just a roundabout way of me saying that I believe there are no such thing as "basic human rights" in any shape or form.
And, honestly, I find this quote insulting to the extreme. You think of me in unflattering (clearly an understatement I think in this case) terms simply because I write something that you disagree with?
It's not an issue of the company recouping the costs, because they made back all the money they probably invested in the first quarter where this medicine was released--and I say probably because the costs of developing medicine and divulging that info is notoriously opaque and obfuscated.
This is not correct in any way - in fact, the "Costs" are publicly available (check filings from any pharma company) On average, a new drug costs $5 billion to bring to market, if you account for the drugs that don't make it to market. Most of those don't become profitable until many years after being on the market.
Also, as far as the american system is concerned, I do think it needs to be pointed out that we are an order of magnitude more responsible for advancing medicine than any other country. If we disincentivize that innovation, we're pretty ****ed. IMO, we need better ways to get money from OTHER countries that unfairly benefit from our expenditures.
Also, as far as the american system is concerned, I do think it needs to be pointed out that we are an order of magnitude more responsible for advancing medicine than any other country. If we disincentivize that innovation, we're pretty ****ed. IMO, we need better ways to get money from OTHER countries that unfairly benefit from our expenditures.
Your link appears to be referring to total publications - I'm not sure if that's a fairer measure of the system than per capita. Per population, by that data, the UK produced about 25% more papers than the US, and the other countries on that graph were pretty close to par.
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Quote from MD »
I am willing to bet my collection that Frozen and Solid are not on the same card. For example, Frozen Tomb and Solid Wall.
If Frozen Solid is not reprinted, you are aware that I'm quoting you in my sig for eternity?
This is not correct in any way - in fact, the "Costs" are publicly available (check filings from any pharma company) On average, a new drug costs $5 billion to bring to market, if you account for the drugs that don't make it to market. Most of those don't become profitable until many years after being on the market.
Also, as far as the american system is concerned, I do think it needs to be pointed out that we are an order of magnitude more responsible for advancing medicine than any other country. If we disincentivize that innovation, we're pretty ****ed. IMO, we need better ways to get money from OTHER countries that unfairly benefit from our expenditures.
Assuming I'm reading this correctly (very possible I am not), then Pfizer reported a profit of $22 billion last year. Drug companies seem to be doing just fine.
So, you're arguing your ideals against all rational argument? Interesting.
I have no idea what you mean by this. Can you explain it a bit more?
As it sounds. Your argument is purely ideological, based in Ayn Rand if I'm not mistaken. Mine, that other people's lack of access to healthcare will impact your health, is based in the medical consensus.
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Card advantage is not the same thing as card draw. Something for 2B cannot be strictly worse than something for BBB or 3BB. If you're taking out Swords to Plowshares for Plummet, you're a fool. Stop doing these things!
Your link appears to be referring to total publications - I'm not sure if that's a fairer measure of the system than per capita. Per population, by that data, the UK produced about 25% more papers than the US, and the other countries on that graph were pretty close to par.
I wasn't presenting it as the only measure - I was presenting it as a significant consideration. I do disagree with per-capita being the correct way to measure. However, we ARE the biggest innovator in medicine and major drops in healthcare expenditures (And therefore revenues) would be extremely detrimental on pretty much every healthcare system in the world. While I don't think that medical r&d is as much a driving force of costs, I think we should focus on ways to offset our r&d on other countries.
Assuming I'm reading this correctly (very possible I am not), then Pfizer reported a profit of $22 billion last year. Drug companies seem to be doing just fine.
Correct. (thought most of it has been fueled by growth in china over the past decade, of which we're on the tail end of)
And this year theyre on track for a bit over half, and thats just gross profits - net might be even lower if r&d costs were higher year over year, and theyre on a multi-year decline in revenues.
Pharma is an insanely volatile and risky industry - the companies in it need good profits in order to stay in the industry.
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Commander Decks G MGC WB Teysa Tokens BR Wortsnort UG 23.5-No Edric URG Noncombo Animar GUB Damia Stax WBR Alesha Hatebear Recursion WBR Daddy Tariel UBR [Je]love-a Your Deck GWU Almost Critterless Enchantress WUB Sydri+Artifacts=WUB WURG Glint-Eye Combo
So, you're arguing your ideals against all rational argument? Interesting.
I have no idea what you mean by this. Can you explain it a bit more?
As it sounds. Your argument is purely ideological, based in Ayn Rand if I'm not mistaken. Mine, that other people's lack of access to healthcare will impact your health, is based in the medical consensus.
I don't think his argument has anything to do with Ayn Rand. You two are debating the question "is healthcare a right?" You're not debating "is healthcare good?" or even "should we provide everyone with healthcare?" The question is whether access to universal healthcare is something so important and inalienable that we consider it to be endowed by god or nature as a basic right that every human possesses.
Practical considerations like "universal healthcare reduces the transmission of infectious diseases" have little or no relevance to the question of rights. If healthcare is a basic human right, then not providing your citizens with universal healthcare is a violation of basic human rights, regardless of any practical considerations. It doesn't matter whether universal healthcare would increase or reduce the rates of infectious disease spread. Either way, it's a right, you need to provide it to people. Even if providing universal healthcare would bankrupt your country, you are morally obligated to provide it, because it's a basic human right. It doesn't matter if universal healthcare would lead to "death panels" like all those nutty conservative conspiracy theorists think it would. Even if it came with death panels, its a right, we have to provide it.
Do you see the issue? If you want to debate rights, you need to make a philosophical argument about why this is a right. Practical considerations matter little or not at all.
As it sounds. Your argument is purely ideological, based in Ayn Rand if I'm not mistaken. Mine, that other people's lack of access to healthcare will impact your health, is based in the medical consensus.
I never read anything written by Ayn Rand, so I don't know if anything I write here are based on Randyian ideology. That being said, I have heard about her ideology and I don't like it that much.
I think you're making the same mistake BatterysRevenge did and think that I want everyone to be self-sufficient or something. No, I don't want that at all.
You know what, let me know where I wrote anything that comes close to my opinion on healthcare in general on this thread. I'm pretty sure the only topics I touched on here are-
1- Whether it's wise for us to take national healthcare advise from countries that have very different demographics than us.
2- My personal opinions on why socialized healthcare in the U.S. has a difficult time working.
3-My personal opinion on whether healthcare is a basic human right or not.
Barrack Obama has been quoted a few times saying how he wanted a system similar to the one in Australia, so we must be doing something right....
I don't know much about Australian healthcare, but on a little bit of research it appears to be similar to the French system in that the government is a universal payer, is that correct?
Correct, but I can't comment on the French system > the government pays for almost everything from staff, supply and the like unless the hospital is private (all emergency services are public & most private hospitals have public sections). If the hospital is private, they get paid by the govt. for treating public patients at the going medicare rate.
Anything life-threatening or considered non-elective is covered (electives like fake boobs are not covered for example, whereas cancer treatment is covered), however on the public wait-list you might be waiting a while for things not considered life-threatening, or you may have a hard time getting seen by certain specialists in a timely manner.
Overall, the public system is very good IME as both a worker and a patient.
.. I was reading today about a Hepatitis C treatment .... It's over $1000 for a single pill.
In the aussie system for example, necessary treatments like this are subsidised by the govt., so whilst most of the time you may have to pay something (like a $20-50 cost to the pharmacist) the medicine is relatively cheap. For example, by brother takes Interferon > a VERY expensive drug that is completely out of reach for someone on a disability pension.
Also, as far as the american system is concerned, I do think it needs to be pointed out that we are an order of magnitude more responsible for advancing medicine than any other country.
If that is true, please save the pats on the back....
Bear in mind how terribly complicated many of these companies has made medical research. Drug/Pharmaceutical companies based in the USA (and elsewhere of course, but USA companies have been quite a large part of this) have unfortunately "patented" certain chemical structures/compound's in order to effectively *own* a drug for a period of some 20yrs. During that time, the companies have been known to aggressively pursue any other entity that uses their compound without paying huge dollars for it, whether it's to develop something good or not.
MANY researchers, which don't have the money to pay these large sums of money, have had their work stymied if not utterly stomped, by these drug companies which have made it clear that their money is more important than developing cures for disease and illness.
For me, this is no different to an obscenely rich person who doesn't do charity and couldn't give a ***** if the common folk just rolled over and died...
I understand that intellectual property etc etc. and all that > but when research is effectively told, "No!, you cannot use that for 20 years", it's a farcical situation when peoples lives are being effected adversely.
I believe every human should have the right to healthcare, regardless of their financial situation.
Should anyone say you need to have a certain amount of money or you can't have access, is a terrible reflection on anyone's soul.
If I was to say that religion or race differences meant some had healthcare and others didn't, I'd be accused of being racist and bigoted, why should money be any different?
I believe every human should have the right to healthcare, regardless of their financial situation.
Why do you believe humans should have a right to healthcare regardless of their financial situation? Does the level of healthcare matter, or is the simple fact that they're covered under some program what's important?
[quote from="magickware99 »" url="http://www.mtgsalvation.com/forums/outside-magic/debate/579904-an-american-asking-the-rest-of-the-1st-world-for?comment=74"]
Should anyone say you need to have a certain amount of money or you can't have access, is a terrible reflection on anyone's soul.
Would you say the same for anything besides healthcare?
[quote from="magickware99 »" url="http://www.mtgsalvation.com/forums/outside-magic/debate/579904-an-american-asking-the-rest-of-the-1st-world-for?comment=74"]
If I was to say that religion or race differences meant some had healthcare and others didn't, I'd be accused of being racist and bigoted, why should money be any different?
There is a difference between saying "You can't get healthcare if you're a Christian" and "You can't get healthcare if you can't pay for it".
Aside from this whole rural area problem, there are some other serious problems deeply connected to the US health care (, again as far as I can tell. If I say something wrong, correct me).
The Americans have a deep trust in their capitalistic view on everything slightly economic. This approach works pretty well in retroperspective over the last 200 years and is one of the reasons for the USA being a leader in industries and technologies for decades. (Now we see a shift in that, but the USA are nonetheless very important for the global market) The capitalistic system results basically in a more concentrated distribution of wealth, while other systems try to distribute it more equally (or completely equal, I'm looking at you communism). So it is natural to have winners, but also loosers in that system. But the US also uses this system for education and health. So two problems arise, both connected.
Doctors of medicine (MD) must have a really good education. The human body is pretty complex and a simple mistake can easily kill someone here. So the education is rather expensive. But if the students have to pay for their college, they must seek a way to make this profitable. Naturally, they become more expensive. (This problem is also given somewhat in the pharmacy, where scientists must search for the best paid job, instead of the most useful one. But the problem here lies more in the economic treatment of the health care.)
The bigger problem: The health care system is not a free market, probably not even a "normal" market in an economic sense. There are some things to consider here: First of, as Jay13x mentioned, people in need of treatment can't just look for a cheaper alternative. When you are in pain, you just go the nearest hospital. That's it. We have one of the toughest problems in economics, too: How do people evaluate things moneywise? Normal goods have an upper bound for what you pay. The problem: Your dying daughter or wife is not a normal good. You will pay almost anything to keep them alive. In a capitalistic market (considering a monopolist) that means you can convert each beloved patient in critical condition to a huge pile of money. Another problem: You loose your customer, if he gets healthy. In a system without ethics or specific laws, pharmaceutical companies and doctors try to prevent patients from becoming healthy. There are more critical problems, but I think that's enough for now. The point is, when you need the medicine from a monopolist (oligopol is no fun either) you have some serious problems.
Even with laws and restrictions, building a hospital or establishing a pharmaceutical company requires huge investments. So the entrance barrier to this market is really high. Then you need to keep hygienic standards, have to buy advanced technology or newer medicine. And your employees must pay for their student loans, so they aren't the cheapest either. So you have high maintenance costs as well. And then there are going to be torts, where sometimes huge sums are at stake. And a law department is another cost factor.
This leads to the next problem: The law system. Even if you do research on your own and you find the next penicillin, you will probably not find a way to legally distribute it. The pharmaceutical companies will block and sue you, bring you before every judge there is and try anything to stop you from being successful. As a sole person you can only hope of getting funded. With huge sums. I suppose, even if you try to sell your recipe to a company, they just steal it from you. They have more lawyers, you will probably never win.
There are many more things to consider, but the point is: If you want to give everyone the chance for some treatment, then the capitalistic view on health care is inherently wrong, since the market to consider is just so different and full of ethical and financial barriers. But if you want a good treatment for those who can afford it, it's probably better than any other system.
If that is true, please save the pats on the back....
Bear in mind how terribly complicated many of these companies has made medical research. Drug/Pharmaceutical companies based in the USA (and elsewhere of course, but USA companies have been quite a large part of this) have unfortunately "patented" certain chemical structures/compound's in order to effectively *own* a drug for a period of some 20yrs. During that time, the companies have been known to aggressively pursue any other entity that uses their compound without paying huge dollars for it, whether it's to develop something good or not.
MANY researchers, which don't have the money to pay these large sums of money, have had their work stymied if not utterly stomped, by these drug companies which have made it clear that their money is more important than developing cures for disease and illness.
For me, this is no different to an obscenely rich person who doesn't do charity and couldn't give a ***** if the common folk just rolled over and died...
I understand that intellectual property etc etc. and all that > but when research is effectively told, "No!, you cannot use that for 20 years", it's a farcical situation when peoples lives are being effected adversely.
This includes patenting disease genomes. You may have heard of the 'controversy' where the CDC patented an Ebola virus (which conspiracy theorists took off with), but the reality is it's the only way to open research on these diseases to more than just a single company.
Nope, that's not what I'm saying at all. Let me keep this simple to begin with, and if you want clarification or me to expound on one of the points I'm about to raise, I'll do so.
And those are just the examples I can think of off the top of my head.
Sure, if you want to go the single-provider route, the Public Health Service could be the model, but I wouldn't recommend it. IHS... has a lot of issues. The Navajo nation is moving towards a self-sufficiency model, where the Navajo staff many of the hospitals out there rather than IHS officers. There are other problems with this model, namely that it's a uniformed service and not something that would necessarily be applicable to the nation as a whole (in that I mean a lot of healthcare providers are NOT good candidates for that kind of structure).
I'm for universal healthcare, however you have to be careful in country to country comparisons. All else removed, physician training isn't consistent between countries, nor are cultural norms or the public's view of healthcare. There are going to be pros and cons for every system out there, and the US has progressed so far down the private insurance road that you can't easily compare it to a countries that have had a universal system set up in a different environment.
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I think there's fundamental confusion or disagreement about what it means for something to be a "basic human right." Just because you think it's smart to provide everyone with healthcare doesn't mean it's a human right. I'm sure some people will disagree with my definition, but I see "basic human right" as an entirely different thing from a policy decision.
A policy decision is something we do (or don't do) because we think it's the best idea under the circumstances. The pros outweigh the cons. We allow people to drive cars because we think the pros of people having the ability to drive around outweighs the cons (like pollution and accidents). If the government decided to outlaw private car ownership tomorrow, many people would argue that this is a dumb decision and would try to get the law changed back. But at the end of the day the right to car ownership isn't a basic human right and it's something that we as a society could decide to get rid of if we thought it made sense.
A basic human right is (in my mind) something that we consider to be so important that we don't even weigh the pros and cons. For example, in the US we say that the right to freedom of speech is a basic human right. Even though 99.9% of people hate the Westboro Baptist Church and think their message is terrible and damaging, we say "they have a right to free speech, it doesn't matter how horrible their message is" and we let them picket funerals.
So in this framework I agree with magicware99 that universal healthcare isn't a basic human right. The fact that people on both sides are debating the pros and cons and talking about feasibility means it's not being talked about like a basic human right. If healthcare was framed as a basic human right, then the rebuttal to arguments like "I don't think universal healthcare would work well in the US" would be "who cares whether it would work well, it's a right and we have to provide it to people no matter the cost."
I guess to me that is largely a separate but related issue... We have the discussion on inefficiencies in the current health care system and a discussion on how to "sell" or "distribute" health care. I was talking purely about distribution given the current inefficiencies. I don't know how feesable it would be to debate both at the same time as it would be quite complicated.
I will still contend that based on geography alone I am not sure that it's possible to provide every rural area with a relatively near by source of what most people would consider to be an acceptable minimum level of health care.
I do agree with you though that the inefficiencies in our health care system are a huge source of problems currently and for any changes. I think that would be a great place to make headway.
Okay, well even assuming the current inefficiencies, it would be possible to provide better healthcare to underserved areas. Which isn't just rural, as an aside. There are many areas of cities that can be considered underserved, or specific populations in cities.
Everyone is always so hung up on solving the problem, they often missing that simply alleviating some of the problem is a good thing.
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How exactly does the possibility of me dying to an infectious disease make me decide that health care should be a basic human right? Is the fear of death supposed to make me decide that healthcare should be a basic human right? How does that even work? All the healthcare in the world won't prevent me from actually dying sooner or later.
My definition of basic human right is roughly similar to bitterroot's. I define it as something that is fundamentally something we possess- the ability for action.
Practically speaking, I define it as the freedom to STRIVE for anything and everything we want. Note that I capitalized STRIVE for a reason; this is a huge difference from the commonplace definition today.
The point is that it is more proper to compare the U.S. to countries that have some similarity between the two. For example, it makes absolutely no sense whatsoever to look at the healthcare system in any of the Scandinavian countries and say we can adapt that system for the U.S. There are simply far too much of a difference between the U.S. and the Scandinavian countries.
A country with a population that is at least over a 100 million is more apt to face issues similar to those faced by the U.S., and so it is a good starting point to make comparisons.
Look at the Atlantic piece I posted earlier. The Brazilian health care, even though it's a national one, still works better for the rich and poorly for the poor. IIRC, the article outright says that the benefits of Brazilian healthcare comes more from different approaches to healthcare than the fact that they have a national one.
Certainly we could, but would it be better to do that by reducing inefficiencies in the care system itself or by changing the way care is distributed? I think reducing inefficiencies in the system would go a longer way than changes to distribution. Let's make the system work better before we worry about how to provide access to an inefficient system to more people.
Quick real world example of crazy health care inefficiency... My Grandfather was the administrator at a hospital and he retired about 15 years ago. While he was the administrator his salary never went into 6 figures.... I know that the current Administrator at that hospital makes something in the range of $300,000+. I also know that while her employees have been on a wage freeze for years her salary has steadily increased every year (and by steadily I mean 20%+ raises).
So, you're arguing your ideals against all rational argument? Interesting.
On phasing:
If you do care about those who cannot afford healthcare, like the impoverished, disabled, mentally ill or those otherwise unable to afford a high cost medical insurance policy, then a socialist model that covers everyone is the only way to go.
Here where I live in Australia, we have Medicare > everyone who earns over a certain amount of cash annually, must pay the medicare levy through your tax to cover it.
The idea being, that ANYONE, ANYTIME can just walk into an emergency dept. and get 1st world-rate healthcare and get their needs attended to.
FOR FREE.
You walk out the door (if able) without spending a buck.
Of course there are holes in the system, like mental health for example (but I doubt any countries in the world actually tackle this well), but the premise remains that emergency healthcare is there for anyone who needs it. Other more long-term needs, like a chronic arthritic hip for example, will eventually get done, but of course the queue is a fair bit shorter if you're willing to front the cash or have private healthcare.
When you look at the stress on the Aussie national budget to provide such a service, it is large, but given the horror stories I've heard about the system in the USA (like insurer's who back out of helping cancer patients and refuse to honour their policy, forcing the patient to sell their house, or worse) I wouldn't want to go to a system like the one in the USA.
FYI;
Barrack Obama has been quoted a few times saying how he wanted a system similar to the one in Australia, so we must be doing something right....
I have no idea what you mean by this. Can you explain it a bit more?
I don't know much about Australian healthcare, but on a little bit of research it appears to be similar to the French system in that the government is a universal payer, is that correct?
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This was also an issue with antiretroviral drugs in Africa.
The reason why you're not already dead from polio or some other childhood disease is because the government invested millions, if not billions of dollars on getting everyone vaccinated against common diseases that would kill people. Your beloved free market wouldn't do that because ongoing treatment for polio patients means more money in their pockets.
I'm interested in finding out if you pay your own health care premiums or if the government or your parents pay for your health care. Because it seems to me that instead of telling other people to strive for anything, you should pay your own way before telling other people to pull themselves up by their bootstraps. Monthly premiums at my old employer were $800 for Aetna HMO with a $7,000 deductible. That would eat up most everyone's paycheck except the ED and VP, who gave themselves raises each year.
I don't love the free market. In fact I don't like it one bit.
And, yes, I would agree with you. Many of us would probably be dead from the terrible diseases that had essentially been eradicated in the U.S. through the vaccine programs.
How exactly does this make me think that healthcare is a basic human right though?
It is one thing to desire a certain something or an outcome, and quite another to call that something/outcome a "basic human right".
I didn't tell people to "pull themselves up by their bootstraps". If that is what you took from the way I define basic human rights, then you're mistaken.
I'm saying that you should have the ability to affect whatever you want, within the constraints of the given law/rule of the time. And if you don't like the law/rules, then you're free to attempt to change the rules. Ideally through an existing method in the governmental framework, but that isn't always possible and so you'd probably have to resort to extralegal means in that case.
Anything that prevents you from attempting these things are a violation of your basic human right.
So if you want to have the government pay for everything you want, then you're perfectly free to attempt to get them to do that.
This is really just a roundabout way of me saying that I believe there are no such thing as "basic human rights" in any shape or form.
And, honestly, I find this quote insulting to the extreme. You think of me in unflattering (clearly an understatement I think in this case) terms simply because I write something that you disagree with?
This is not correct in any way - in fact, the "Costs" are publicly available (check filings from any pharma company) On average, a new drug costs $5 billion to bring to market, if you account for the drugs that don't make it to market. Most of those don't become profitable until many years after being on the market.
Also, as far as the american system is concerned, I do think it needs to be pointed out that we are an order of magnitude more responsible for advancing medicine than any other country. If we disincentivize that innovation, we're pretty ****ed. IMO, we need better ways to get money from OTHER countries that unfairly benefit from our expenditures.
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Your link appears to be referring to total publications - I'm not sure if that's a fairer measure of the system than per capita. Per population, by that data, the UK produced about 25% more papers than the US, and the other countries on that graph were pretty close to par.
Assuming I'm reading this correctly (very possible I am not), then Pfizer reported a profit of $22 billion last year. Drug companies seem to be doing just fine.
http://www.pfizer.com/news/press-release/press-release-detail/pfizer_reports_fourth_quarter_and_full_year_2013_results_provides_2014_financial_guidance
As it sounds. Your argument is purely ideological, based in Ayn Rand if I'm not mistaken. Mine, that other people's lack of access to healthcare will impact your health, is based in the medical consensus.
On phasing:
I wasn't presenting it as the only measure - I was presenting it as a significant consideration. I do disagree with per-capita being the correct way to measure. However, we ARE the biggest innovator in medicine and major drops in healthcare expenditures (And therefore revenues) would be extremely detrimental on pretty much every healthcare system in the world. While I don't think that medical r&d is as much a driving force of costs, I think we should focus on ways to offset our r&d on other countries.
Correct. (thought most of it has been fueled by growth in china over the past decade, of which we're on the tail end of)
And this year theyre on track for a bit over half, and thats just gross profits - net might be even lower if r&d costs were higher year over year, and theyre on a multi-year decline in revenues.
Pharma is an insanely volatile and risky industry - the companies in it need good profits in order to stay in the industry.
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I don't think his argument has anything to do with Ayn Rand. You two are debating the question "is healthcare a right?" You're not debating "is healthcare good?" or even "should we provide everyone with healthcare?" The question is whether access to universal healthcare is something so important and inalienable that we consider it to be endowed by god or nature as a basic right that every human possesses.
Practical considerations like "universal healthcare reduces the transmission of infectious diseases" have little or no relevance to the question of rights. If healthcare is a basic human right, then not providing your citizens with universal healthcare is a violation of basic human rights, regardless of any practical considerations. It doesn't matter whether universal healthcare would increase or reduce the rates of infectious disease spread. Either way, it's a right, you need to provide it to people. Even if providing universal healthcare would bankrupt your country, you are morally obligated to provide it, because it's a basic human right. It doesn't matter if universal healthcare would lead to "death panels" like all those nutty conservative conspiracy theorists think it would. Even if it came with death panels, its a right, we have to provide it.
Do you see the issue? If you want to debate rights, you need to make a philosophical argument about why this is a right. Practical considerations matter little or not at all.
I never read anything written by Ayn Rand, so I don't know if anything I write here are based on Randyian ideology. That being said, I have heard about her ideology and I don't like it that much.
I think you're making the same mistake BatterysRevenge did and think that I want everyone to be self-sufficient or something. No, I don't want that at all.
You know what, let me know where I wrote anything that comes close to my opinion on healthcare in general on this thread. I'm pretty sure the only topics I touched on here are-
1- Whether it's wise for us to take national healthcare advise from countries that have very different demographics than us.
2- My personal opinions on why socialized healthcare in the U.S. has a difficult time working.
3-My personal opinion on whether healthcare is a basic human right or not.
Ok.
How does that make medicine a basic human right?
Oh, and what does this have anything to do with what I wrote?
Correct, but I can't comment on the French system > the government pays for almost everything from staff, supply and the like unless the hospital is private (all emergency services are public & most private hospitals have public sections). If the hospital is private, they get paid by the govt. for treating public patients at the going medicare rate.
Anything life-threatening or considered non-elective is covered (electives like fake boobs are not covered for example, whereas cancer treatment is covered), however on the public wait-list you might be waiting a while for things not considered life-threatening, or you may have a hard time getting seen by certain specialists in a timely manner.
Overall, the public system is very good IME as both a worker and a patient.
In the aussie system for example, necessary treatments like this are subsidised by the govt., so whilst most of the time you may have to pay something (like a $20-50 cost to the pharmacist) the medicine is relatively cheap. For example, by brother takes Interferon > a VERY expensive drug that is completely out of reach for someone on a disability pension.
If that is true, please save the pats on the back....
Bear in mind how terribly complicated many of these companies has made medical research. Drug/Pharmaceutical companies based in the USA (and elsewhere of course, but USA companies have been quite a large part of this) have unfortunately "patented" certain chemical structures/compound's in order to effectively *own* a drug for a period of some 20yrs. During that time, the companies have been known to aggressively pursue any other entity that uses their compound without paying huge dollars for it, whether it's to develop something good or not.
MANY researchers, which don't have the money to pay these large sums of money, have had their work stymied if not utterly stomped, by these drug companies which have made it clear that their money is more important than developing cures for disease and illness.
For me, this is no different to an obscenely rich person who doesn't do charity and couldn't give a ***** if the common folk just rolled over and died...
I understand that intellectual property etc etc. and all that > but when research is effectively told, "No!, you cannot use that for 20 years", it's a farcical situation when peoples lives are being effected adversely.
I believe every human should have the right to healthcare, regardless of their financial situation.
Should anyone say you need to have a certain amount of money or you can't have access, is a terrible reflection on anyone's soul.
If I was to say that religion or race differences meant some had healthcare and others didn't, I'd be accused of being racist and bigoted, why should money be any different?
Why do you believe humans should have a right to healthcare regardless of their financial situation? Does the level of healthcare matter, or is the simple fact that they're covered under some program what's important?
Would you say the same for anything besides healthcare?
There is a difference between saying "You can't get healthcare if you're a Christian" and "You can't get healthcare if you can't pay for it".
The Americans have a deep trust in their capitalistic view on everything slightly economic. This approach works pretty well in retroperspective over the last 200 years and is one of the reasons for the USA being a leader in industries and technologies for decades. (Now we see a shift in that, but the USA are nonetheless very important for the global market) The capitalistic system results basically in a more concentrated distribution of wealth, while other systems try to distribute it more equally (or completely equal, I'm looking at you communism). So it is natural to have winners, but also loosers in that system. But the US also uses this system for education and health. So two problems arise, both connected.
Doctors of medicine (MD) must have a really good education. The human body is pretty complex and a simple mistake can easily kill someone here. So the education is rather expensive. But if the students have to pay for their college, they must seek a way to make this profitable. Naturally, they become more expensive. (This problem is also given somewhat in the pharmacy, where scientists must search for the best paid job, instead of the most useful one. But the problem here lies more in the economic treatment of the health care.)
The bigger problem: The health care system is not a free market, probably not even a "normal" market in an economic sense. There are some things to consider here: First of, as Jay13x mentioned, people in need of treatment can't just look for a cheaper alternative. When you are in pain, you just go the nearest hospital. That's it. We have one of the toughest problems in economics, too: How do people evaluate things moneywise? Normal goods have an upper bound for what you pay. The problem: Your dying daughter or wife is not a normal good. You will pay almost anything to keep them alive. In a capitalistic market (considering a monopolist) that means you can convert each beloved patient in critical condition to a huge pile of money. Another problem: You loose your customer, if he gets healthy. In a system without ethics or specific laws, pharmaceutical companies and doctors try to prevent patients from becoming healthy. There are more critical problems, but I think that's enough for now. The point is, when you need the medicine from a monopolist (oligopol is no fun either) you have some serious problems.
Even with laws and restrictions, building a hospital or establishing a pharmaceutical company requires huge investments. So the entrance barrier to this market is really high. Then you need to keep hygienic standards, have to buy advanced technology or newer medicine. And your employees must pay for their student loans, so they aren't the cheapest either. So you have high maintenance costs as well. And then there are going to be torts, where sometimes huge sums are at stake. And a law department is another cost factor.
This leads to the next problem: The law system. Even if you do research on your own and you find the next penicillin, you will probably not find a way to legally distribute it. The pharmaceutical companies will block and sue you, bring you before every judge there is and try anything to stop you from being successful. As a sole person you can only hope of getting funded. With huge sums. I suppose, even if you try to sell your recipe to a company, they just steal it from you. They have more lawyers, you will probably never win.
There are many more things to consider, but the point is: If you want to give everyone the chance for some treatment, then the capitalistic view on health care is inherently wrong, since the market to consider is just so different and full of ethical and financial barriers. But if you want a good treatment for those who can afford it, it's probably better than any other system.
This includes patenting disease genomes. You may have heard of the 'controversy' where the CDC patented an Ebola virus (which conspiracy theorists took off with), but the reality is it's the only way to open research on these diseases to more than just a single company.
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