USA healthcare debate about 'socialised medicine' rages

[weepiper]

I went to hospital in the US when I lived in the US aged 12 with a badly gashed leg (10 stitches ) and despite the fact I was bleeding profusely they made my mum sort out the insurance before I was let onto the ward.

that was my mum's experience when my brother broke his arm in Maryland in 1981. Don't know if it's still the same now mind

 

[ymu]

NIHCE have always refused to state what their threshold for cost-effectiveness is, but it's not difficult to look at what they've approved and work out that it's around £30,000 per QALY (for one perfect year of health,, a quality adjusted life-year), which is roughly what the ad states.

That doesn't mean that any treatment costing more than £30k is turned down - it depends what improvements to length and quality of life it offers. Any rational healthcare system with a fixed budget has to have a threshold for cost-effectiveness - whether it's £30k or £50k or £100k. The NHS fixed budget allows us to spend up to £30k/QALY - if we spend more than that on one group of patients we are not spending it on another group who would gain more benefit from the same expenditure.

I do agree that the advert is pants though. What it doesn't point out is that the US pays three times as much, on average, per capita on healthcare for the worst health outcomes of any developed nation, and that they have the highest drug prices in the world, precisely because they refuse to contemplate "rationing" (aka rational allocation of resources).

 

[DotCommunist]

Yeah, I know that on minimum wage you're still screwed, sadly.

What is the other side of the fines for those without insurance, though? I'd imagine Obama as the type who brings a carrot as well as a stick (and I strongly suspect this stick is actually a carrot for those who think the coffers will be drained by 'the feckless poor).

Re: the sustainability of the British model, this is quite a good article:

http://www.bmj.com/cgi/reprint/336/7658/1410.pdf

I currently can't find any sources that are not rabidly r/w, but this is from a brief google

http://www.azcentral.com/business/articles/2009/07/02/20090702biz-healthcare0702.html

 

[8ball]

What it doesn't point out is that the US pays three times as much, on average, per capita on healthcare for the worst health outcomes of any developed nation, and that they have the highest drug prices in the world, precisely because they refuse to contemplate "rationing" (aka rational allocation of resources).

Broadly similar to the figures I've seen. Certainly looks like they're paying more and getting less, rather than the other way round.

 

[DotCommunist]

Broadly similar to the figures I've seen. Certainly looks like they're paying more and getting less, rather than the other way round.

it's a small price to pay to avoid SOCIALISM

After all, why should any of MY MONEY go to patching up my sick nieghbour, he's a fucking lazy cunt and should just die ennit

 

[8ball]

I currently can't find any sources that are not rabidly r/w, but this is from a brief google

http://www.azcentral.com/business/articles/2009/07/02/20090702biz-healthcare0702.html

Don't want to diss it too much without seeing figures, but it looks like the kind of 'shared payment' plan between individuals, Government and employers that Blair would have creamed himself over if he could ever have got away with suggesting it.

 

[8ball]

it's a small price to pay to avoid SOCIALISM

After all, why should any of MY MONEY go to patching up my sick nieghbour, he's a fucking lazy cunt and should just die ennit

Sadly, this is the entirety of the counterargument.

 

[butchersapron]

Lord Obama isn't socialising medicine bythw

 

[Yossarian]

it's a small price to pay to avoid SOCIALISM

After all, why should any of MY MONEY go to patching up my sick nieghbour, he's a fucking lazy cunt and should just die ennit

It's your HEALTH! The most important thing you have, and those BUREAUCRATS want to put it into the hands of the GOVERNMENT - and then TAX you!

 

[butchersapron]

Medicaid, iirc, doesn't kick in unless you are completely devoid of funds. So the minimum wage worker has to pay his medical bills in full. As I understand it this health bill woll be threatening fines for those who don't have even a basic health plan.

medicaid is largely being REMOVED as part of this plan to further marketise health provsiion.

 

[Lo Siento.]

course in our ¨socialised medicine¨ you can still pay for private treatment if you want it. It´s a choice, innit.

 

[DotCommunist]

medicaid is largely being REMOVED as part of this plan to further marketise health provsiion.

do you have any further info on this? the whole thing stinks of the sort of pretend-benevolence so beloved of the democrats.

 

[mrs quoad]

Actually, I know that you have an average patient cost ( about £1900) and that it is slightly higher in Scotland than the UK ( about £2100), but where on earth could they have got this figure from?

Possibly from the price NICE believes it's worth paying for a drug, if it will extend someone's life by 6 months?

My dad used to quote summat like £7,400 as the price of a human life. Which was British Transport's cutoff (in the 1970s or summat) for life-saving / preventative measures. If a life-saving measure was believed to save one life and it cost LESS than £7,400ish, bonzer. If it cost MORE than £7,400 then sod it.

Obv that could be multiplied up etc etc for multiples of one life / multiples of £7,400.

 

[8ball]

medicaid is largely being REMOVED as part of this plan to further marketise health provsiion.

Hmmm, this looks more nuanced and it doesn't look too 'political' - more like consumer advice:

http://www.baltimoresun.com/business/money/sns-health-obama-townhallqa,0,6524273.story

We've got heaps of Septics on Urban, should be able to ask them in a couple of hours . . .

 

[Combustible]

The right wing in America regularly lie about the NHS and the Canadian health system. Although Obama's healthcare plan is terrible and not at all socialised. There is one area of American healthcare which is pretty much 'socialised' as far as I know and that is veterans' care. Of course the right wingers will simultaneously justify the care for veterans on the grounds that wounded soldiers deserve the best yet say that if applied to the whole population loads more would die.

 

[toblerone3]

Possibly from the price NICE believes it's worth paying for a drug, if it will extend someone's life by 6 months?

My dad used to quote summat like £7,400 as the price of a human life. Which was British Transport's cutoff (in the 1970s or summat) for life-saving / preventative measures. If a life-saving measure was believed to save one life and it cost LESS than £7,400ish, bonzer. If it cost MORE than £7,400 then sod it.

Obv that could be multiplied up etc etc for multiples of one life / multiples of £7,400.

I believe that NICE's approximate threshhold of £30,000/QUALY was originally based on the Department of Transport's willingness to pay guidelines for preventing fatal road accidents.

 

[ymu]

The Aussies had a good system. They'd offer to buy a drug at their threshold cost per QALY. Expensive drugs would have to lower their price to get used, and some particularly good value drugs attracted a price premium. I believe it's now been dismantled. One of Bush's conditions for free trade agreement.

 

[rikwakefield]

Money really does bring out the worst in people.

 

[Missez]

Someone just sent me this link from an American business editorial.

http://www.ibdeditorials.com/IBDArticles.aspx?id=333933006516877

People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.

 

[Mrs Magpie]

I wish the soviets had won the cold war, sometimes.

Our doctors would have to wear those doctors hats....

 

[Jazzz]

FFS, isn't this just misrepresentative libellous bollocks? What is not wrong with this advert?

I don't see much wrong with it TBH. It seems factually correct, and is highlighting the reality that values are put on life in cost-benefit analyses in such a healthcare system.

Par for the course.

You do realise that political adverts are allowed to be biased?

 

[Jazzz]

I mean, of course I don't take their side in the slightest - we don't have people just dying on the street when they are ill and have no money. But democracy means allowing the wrong side to put their case

 

[Jazzz]

the US pays three times as much, on average, per capita on healthcare for the worst health outcomes of any developed nation

They are the most heavily vaccinated.

 

[xenon]

Health spending is 17.6% of the US economy. Of course they're going to go to great lengths to protect a system that forces people to pay more for less.

Yeah. I read somewhere, The Undercover Economist I think. They're system as is, is actually more expensive per capiter than the NHS. Largely down to the administration costs.

 

[editor]

It's being elevated into a huge political battleground and the Republicans are using it to discredit Obama. There's been a spate of loud protests at local meetings which are raising suspicions that it's part of a dodgy campaign:

Grassroots or astroturf? Real or fake?

Those are the questions being asked about the rash of protests taking place all over the country against the president's plans to reform the nation's healthcare.

Many Congressional Democrats are facing angry constituents at "town hall" meetings.

What is meant to be an opportunity to exchange views and listen has turned into something more like a bar-room fight.

At one such meeting, the police were called in to restore order. One Congressman has received death threats, another has faced an effigy hanging by a rope.

Placards warn of "health rationing" and "socialised medicine"; chants of "Just Say No!" are commonplace.

Democratic senators and representatives - who have just gone home for the summer - may now be wishing they had stayed in humid Washington instead.

Tiny rump?

So are the "grassroots" genuinely angry, or are the protests simply manufactured "astroturf"?

That depends largely on your politics - or whether you watch the liberal MSNBC or conservative Fox News.

http://news.bbc.co.uk/1/hi/world/americas/8194485.stm

*threads merged

 

[Mooncat]

Ah - the infamous Teabaggers.

http://www.sadlyno.com/archives/23831.html

 

[kyser_soze]

Currently polling meta-data suggests that 61% favour BHOs healthcare reforms, and 63% of Americans support the higher taxation of the rich to pay for it.

It will come as no surprise to find that the Democrats who have called for the legislation to be watered down are 'Blue Dog' (i.e. conservative) Dems. What will surprise people even less is that the Blue Dog democrats are the best funded for their upcoming reelection campaigns, and that most of that money in the last 8 months has come from...private healthcare concerns, lobbyists and any other group that can give money to US politicians.

Anyone willing to say there might be a connection?

 

[kyser_soze]

Someone just sent me this link from an American business editorial.

http://www.ibdeditorials.com/IBDArticles.aspx?id=333933006516877

I've just emailed that website back pointing out that having motor-neuron disease doesn't discount you from getting NHS treatment...

 

[spring-peeper]

I've just emailed that website back pointing out that having motor-neuron disease doesn't discount you from getting NHS treatment...

They will consider you a liar

 

[Badger Kitten]

I don't see much wrong with it TBH. It seems factually correct, and is highlighting the reality that values are put on life in cost-benefit analyses in such a healthcare system.

Par for the course.

You do realise that political adverts are allowed to be biased?

But surely not containing things that are blatantly untruthful, such as claiming that the NHS refuses to treat people once care costs a certain amount, given in this instance as £13,800?

I mean that's just a blatant lie.