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Old 19-11-2011, 02:46   #61
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Re: Health Care in USA for Cruisers

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David-
What is a "socialised Army," ? That doesn't quite translate into Colonial. And there's quite some debate about our Veteran's Administration (VA) hospital/medical system depite many changes in recent years.
It's when a society contributes money to a central pot because together they can do things that individually simply cannot be done. i.e. having an Army for stuff like invading Iraq which even by the more optimistic Yeehadists was probably always intended to be more than a one man operation - Rambo not being a real person

Exactly the same principle applies to healthcare. Some of us may be capable of performing open heart surgery on ourselves , but really only makes sense to do that stuff collectively - it's not as if it isn't already - the "debate" is simply about how the money is collected and who gets it.

Of course "efficiency" is something that the private sector claims to have over the public sector - right to a degree, but only when it comes to serving self interest. Usually short term..........and IME systemic stupidity within large organisations is par for the course - in both

I write all the above as someone more on the Freemarketeer end of Capitalism - just that I think some things are the mark of a civilised society . Then again, if I got a dollar for shooting every sick person would probably buy a machine gun .
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Old 19-11-2011, 02:55   #62
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Re: Health Care in USA for Cruisers

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Jeepers. Your health premium is over 10k a year !!!!
Moral. Do not get sick in the US. What processes the US to let that system develop.

Dave
Lawsuits. Lawyers control much of Washington and that is not likely to change. Medical costs will continue to rise. Premiums have increased substantially this year in anticipation of implementation of our 'ever-so-wonderful new mandatory private insurance' scheme that will begin phasing in soon.

We utilized the Australian public healthcare system when our grandson broke both bones in his forearm when we were cruising there. Wonderful system. Cannot praise the Queensland public healthcare system more highly. For $189.50 our grandson received care than would have cost minimum $10,000 in the USA.

Judy
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Old 19-11-2011, 03:53   #63
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Interesting thread. It has a big impact on cruisers wanting to visit the US. I know my health plan wants to repatriate me ASAP if I fall ill in the US.

I have no political axe to grind. I always find the term socialised medicine a funny exclusively US term, more designed to generate partisan arguments then describe the system. the correct term is public healthcare.

It's just strange, The US funds many things centrally yet healthcare is a blind spot. Even in countries with dual private insurance and public healthcare, insurance costs are nothing like the US

I think the UK has it right, universal free healthcare irrespective of age, illness or income. Yes it's expensive but I don't think anyone would do away with the NHS.

Dave
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Old 19-11-2011, 05:46   #64
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Re: Health Care in USA for Cruisers

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Originally Posted by David_Old_Jersey View Post
. Then again, if I got a dollar for shooting every sick person would probably buy a machine gun .

Why a machine gun? Only going to need a single shooter if you start with the very first sick" person you come across. You probably wouldn't be able to shot anyone after that.
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Old 19-11-2011, 05:55   #65
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Re: Health Care in USA for Cruisers

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Originally Posted by David_Old_Jersey View Post
....

Of course "efficiency" is something that the private sector claims to have over the public sector - right to a degree, but only when it comes to serving self interest. Usually short term..........and IME systemic stupidity within large organisations is par for the course - in both

I write all the above as someone more on the Freemarketeer end of Capitalism - just that I think some things are the mark of a civilised society . Then again, if I got a dollar for shooting every sick person would probably buy a machine gun .
Couldn't agree more. If we had a system that was even vaguely efficient due to its private, capitalist nature, then that would not be bad. But what the US has is a system that costs much more per person than any other industrialized country, yet offers worse out comes overall. Maybe health care should be considered too-big-to-fail and fixed.
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Old 19-11-2011, 06:33   #66
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Re: Health Care in USA for Cruisers

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In my experience, every country has a few things that are complete folly. For the US, paying for healthcare is probably tops on the list. A US based pharmaceutical company by law gets to charge twice as much for a pill to an American as the same pill sold to a Norwegian.

Carl
The argument about different drug costs in different countries as a problem of greed, or even folly, is a red herring. It is called capitalism and supply and demand. It is no different for any other product sold around the world. You will pay twice as much for a computer in Panama than you will in the US. What are you Brits paying for a pair of Levi's compared to those in the US?

Like any company with any commodity, pharmaceutical companies set prices based on what they can get for their product. There is nothing wrong with this practice - in fact, the entire world economy is based on it.

It is not wrong to charge double or triple the price in the US just because the US medical care system will support those payments. It is not greed or heartlessness on the part of the pharmaceutical companies (well, it is greed, but no different than any other type of company).

There is nothing sacrosanct about healthcare in an uncontrolled marketplace, like the US prefers to have. If the US didn't want to pay that amount, they wouldn't. Just like the Canadians, the British, and almost every other country in the world won't pay it. But time and again, the US population takes a vote on this issue and resoundingly agrees that it does want to pay exorbitant prices for healthcare. In fact, the US population DEMANDS it, and denigrates other countries who don't pay as much, as well as demonizes those citizens who do prefer lower healthcare costs.

Instead, the US prefers to spend its money subsidizing corn and sugar to provide cheap ethanol, high fructose corn syrup and sweets to the American public rather than cheap medical care. And Americans demand this cheap alcohol and unhealthy food and demand that the government keep their hands out of their healthcare. So they are getting what they demand and vote for.

Don't blame the pharmaceutical companies for pricing their products to the market. Blame the market.

Nobody in the US complains about all other government subsidized industries and this type of socialism. And they don't complain about spending billions subsidizing the military-industrial complex, to name just another example of existing socialism and subsidy. So I don't understand why they are so violently against bringing healthcare into the fold.

However, it is always interesting to hear the same people screaming about socialism and keeping the government out of their healthcare also scream at the government to make pharmaceutical companies and hospitals lower their prices, give them medicare and VA benefits and keep increasing social security benefits.

The irony seems to escape them...

Mark
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Old 19-11-2011, 06:53   #67
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Re: Health Care in USA for Cruisers

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The argument about different drug costs in different countries as a problem of greed, or even folly, is a red herring. It is called capitalism and supply and demand. .....
It is not wrong to charge double or triple the price in the US just because the US medical care system will support those payments. It is not greed or heartlessness on the part of the pharmaceutical companies (well, it is greed, but no different than any other type of company).
.....Don't blame the pharmaceutical companies for pricing their products to the market. Blame the market.
....Mark
Except that the pharmaceutical company is not a free market entity. They are a government protected essential monopoly, i.e. the regulations decide who can manufacturer drugs, who can sell them and who can prescribe them. The difference in international pricing is due to protectionism, not supply and demand. It is the regulations, supported by the pharmaceutical industry, that prohibits me from importing my drugs from a country outside the US - at a much reduced price.
This is not a free market, capitalistic decision, it is market manipulation that is wholesale inefficient. That's why it needs to be changed.
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Old 19-11-2011, 07:29   #68
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Re: Health Care in USA for Cruisers

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Originally Posted by Paul L View Post
Except that the pharmaceutical company is not a free market entity. They are a government protected essential monopoly, i.e. the regulations decide who can manufacturer drugs, who can sell them and who can prescribe them. The difference in international pricing is due to protectionism, not supply and demand. It is the regulations, supported by the pharmaceutical industry, that prohibits me from importing my drugs from a country outside the US - at a much reduced price.
This is not a free market, capitalistic decision, it is market manipulation that is wholesale inefficient. That's why it needs to be changed.
Yes, there are safety regulations associated with being a pharmaceutical company. I don't think anyone is in favor of letting just anybody manufacture anything they want, make any claims they want and sell without testing and conforming to acceptable rules. This isn't protecting a monopoly, it is used throughout all industries.

You are wrong about the cause of international pricing differences, as well as government supported monopolies and market manipulation.

All of your arguments are taken down by the fact that half the pharmaceutical companies in the world are not US companies, and many of them do not even have facilities in the US. There is no US oversight of, nor involvement in these companies outside the FDA requirements that a drug needs to pass certain safety and efficacy tests to be sold. These requirements are universal throughout the world for ethical pharma companies. And yet, they price all of their drugs higher in the US than elsewhere also. And they too are prohibited from being imported cheaper, just like drugs from US companies.

Importing cheaper drugs does not solve the healthcare problem in the US. If you break your arm and are treated in the US, to a first approximation the cost of your prescription drugs will be zero.

The importation regulations exist for many other goods outside of pharmaceuticals. You can't import handbags and shoes sold cheaper elsewhere either. Same with beef, corn, sugar, rice - this list goes on to cover almost all products. It is not market manipulation, although it is protectionism. And you can go to Canada, or mail order from them for your drugs. The importation rules are to prevent companies from being set up to do so. So while I agree that these regulations are supported by the pharmaceutical industry, they are acting like all other companies.

Again, healthcare is not sacrosanct in an uncontrolled marketplace. It is just another commodity like any other. If one doesn't agree with this, one has to change, or take control of the market. You cannot complain about it.

Maybe it isn't clear from my writings, but I don't agree with protecting the market and I don't agree with the current healthcare market system in the US. I want the current system taken down to the bones and a single-payer system run by the government put in its place.

But I do have the ability to step back, see the current system for what it is and stop blaming any single individual piece for the problem. And the pharmaceutical companies are just doing business like any other company. I think the healthcare aspect of their business makes it more emotional and difficult to understand for people than if they were selling handbags.

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Old 19-11-2011, 10:23   #69
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Re: Health Care in USA for Cruisers

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.....

Again, healthcare is not sacrosanct in an uncontrolled marketplace. It is just another commodity like any other. If one doesn't agree with this, one has to change, or take control of the market. You cannot complain about it.

Maybe it isn't clear from my writings, but I don't agree with protecting the market and I don't agree with the current healthcare market system in the US. I want the current system taken down to the bones and a single-payer system run by the government put in its place.

But I do have the ability to step back, see the current system for what it is and stop blaming any single individual piece for the problem. And the pharmaceutical companies are just doing business like any other company. I think the healthcare aspect of their business makes it more emotional and difficult to understand for people than if they were selling handbags.

Mark
Yea, I must have clearly miss read your post. I am in complete agreement with the tear it down and use a single-payer system. I think you are being over generous to the FDA and the medical industry (including pharmaceuticals). Many of the rules in place are supported by the industry and even proposed by the industry to keep a high barrier to entry from competition. This keeps their profits high and low-cost innovation away. The protectionism you mention as being equal to agriculture protectionism might also be considered a red-herring. In the US we have a very low-cost of food. That cannot be said for drugs. So the protectionism is not helping the consumer in this case, it is helping the industry.
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Old 19-11-2011, 10:36   #70
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Re: Health Care in USA for Cruisers

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The protectionism you mention as being equal to agriculture protectionism might also be considered a red-herring. In the US we have a very low-cost of food. That cannot be said for drugs. So the protectionism is not helping the consumer in this case, it is helping the industry.
Most farming in the US is subsidized to keep the cost of food production low. The actual production cost is much higher and would be transferred to the cost of food products if it wasn't so heavily subsidized. It is one of the sticking points with other countries in trade agreements, who can't compete on equal terms.

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Old 19-11-2011, 10:46   #71
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Re: Health Care in USA for Cruisers

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Lawsuits. Lawyers control much of Washington and that is not likely to change. Medical costs will continue to rise. Premiums have increased substantially this year in anticipation of implementation of our 'ever-so-wonderful new mandatory private insurance' scheme that will begin phasing in soon.

We utilized the Australian public healthcare system when our grandson broke both bones in his forearm when we were cruising there. Wonderful system. Cannot praise the Queensland public healthcare system more highly. For $189.50 our grandson received care than would have cost minimum $10,000 in the USA.

Judy
Judy considering we are a small island of maybe 30million people it's not a bad system.... Surely it gets cheaper with a larger taxbase like the USA has???
Are some of the problems a divided state issue? cheers frank
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Old 19-11-2011, 10:46   #72
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Re: Health Care in USA for Cruisers

in any system that depends on insurance to fund it, costs rocket, this is as true for healtcare as it is for auto repairs. Unless you have cost control you get into a price spiral as all the healthy people are subsidising the insurance companies to allow them to pay for the huge costs of the sick ones without caring too much.

Dave
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Old 19-11-2011, 14:29   #73
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Re: Health Care in USA for Cruisers

Not exactly the answer to your question but it's important to carry records with you showing blood profile every six months, names and dosages of all prescriptions, shots, reports from recent doctor visits. Walk-in clinics are a good way to deal with all but major emergencies. I was running on beach with the dog, came down hard on a board with a nail. First question at walk-in (actually limp-in) clinic was when I'd had my last tetanus shot.
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Old 19-11-2011, 14:56   #74
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Re: Health Care in USA for Cruisers

Yes thats a good idea, wow Janet it's 5 pages now and still getting bigger, all i asked was for the name of a good provider!!!!

I'll ask one now about boat insurance see how that goes!! Cheers Frank.....
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Old 19-11-2011, 15:46   #75
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Re: Health Care in USA for Cruisers

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in any system that depends on insurance to fund it, costs rocket, this is as true for healtcare as it is for auto repairs. Unless you have cost control you get into a price spiral as all the healthy people are subsidising the insurance companies to allow them to pay for the huge costs of the sick ones without caring too much.

Dave
Dave has it right. Look at the escalation in med cost since the advent of medicare in the 60's. If some one else pays you use it. The only way to control cost is through a rational method of what is and is not payed for. We would not deny treatment of a terminal illness, but maby that treatment should be palitive care not agressive chemo. More preventive care. I had a close friend in the Netherlands suffering from liver ca, who received great care, but it was more home based and palitive.
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