It's your own fault for living somewhat responsibly!

(Sorry about your situation.)

The problem with socialized medicine is that it will cost the tax payers way more per year than it would to buy private insurance.  Once the government gets involved, everything becomes very poorly managed and wasteful.

Hell, I'll pay in to Social Security my entire life.  Social Security is expected to be bankrupt about 5 years before I retire.  Great job, government!

I totally believe in putting money where your mouth is.  I give money to people when I feel that they need it, and I donate and/or get involved with causes that I feel strongly about.  However, I don't expect others to be forced to do the same.

This is so relevant to the research I am doing right now in preparation for my MPA.

The policy makers that manage foundations (administrators) and government programs are the SAME PEOPLE.  They come from the same pool of professionals.

The difference between the two is the constitution.  Gov run things have to filter their decisions through the rights of every individual and not just a select few.  It is like an obstacle course and hard to navigate.

A private foundation is run by the same type people, same training, same code of ethical conduct, but they don't have to worry about the constitution because its not being funded by the people.

We will never get the same sort of efficiency from gov (because of the very constitution we hold dear) and private foundations.  Ever.

When a problem is so significant that it threatens the well being of our nation, then yeah, I think the gov should be involved in its administration, even if it becomes less efficient.

Generally tho, I agree that foundations are a more efficient way to go.  However, they are limited then in scope and usually funding no matter how wealthy the contributors, and a foundation is also more susceptible to economic atmosphere, and frankly whim.  Not something I would want to count on if say my kid can't walk and I need daily assistance with him.

Foundation/not for profit success is hard to "guage" because profit isn't the indicator of success or failure.  If the foundation's goal is to help people bake pies, and they do that consistently then "technically" its a success, no matter how much money it costs, or how FEW people it helps.

The tweaking and success is usually done after its up and running.  Ok, last year we helped 15 people makes pies, our research dept shows there is a whole city of pie makers in Toledo who need help.  So how do we go inter-state?  How do we reach those people?  What are the guidelines?  How can we do it cost effective?

Tex, I' don't know if this is right.  Have you called Tricare (not the local office but the 1800/888 number and told them you want to do this?)

I went to see a Dr that wasn't Tricare approved because he was the best and I was tired of military hacks.  Tricare still paid 50%, and I believe if you have a referral to go off base to have the baby then you can pick your own care and are only responsible for what Tricare doesn't pay.

Have you talked to the birth center and asked them if they deal with Tricare at all?

You can't trust the local people to really know Tricare.  I was told when I went off base to have Hunter that "Tricare will pay unless there are complications and you need a c-section."

When I called the regional guy he laughed and said, that was totally wrong.  Now imagine if I made my choices based on the local guys info.  Then he sent me the explanation of benefits (which I always threw in the garbage..I know, I know) so I could read it for myself.

Do you have a EOB?  If not GET ONE..you'll be surprised how much is actually covered.  Or go to their website.

Karma,

I respectfully disagree! Here in Canada socialized medicine, overall, means that per capita we pay less for health care through taxes than you would through private channels in the states. This is because, for each province there is one medical system. Whereas in the states you can have a thousand different HMO's in one state with a thousand different billing systems and a thousand different corporate policy systems, as LW so painfully has illustrated with the issues with an out of state healthcare provider. Also, the government is not in it to make a profit. Each and every single HMO must make a profit on your premiums in order to stay in business. The best way to ensure profits stay up is to reduce operating expenses. The best way to reduce operating expenses is to try as hard as possible to no have to pay expensive claims.

The end result of socialized medicine isn't the horror story of lies that seem to be routinely fed to folks in the States. Actually, Canadians have a longer lifespan than Americans and lower infant mortality rate.

The downside of a socialized system is that yes, there are indeed waiting lists. Yes, for non-critical procedures you may have to wait awhile. But, the key here is that no one gets left behind. And critical or necessary operations of course take precedence and are taken care of in short order.

But, on the plus side, if I lose my job, or perhaps fall on hard times for whatever number of plausible reasons, I don't have to worry about going bankrupt or taking out a second mortgage to pay thousands of dollars in medical bills.

There's one other aspect to this situation that's been left out.

We've talked about the pros and cons of charity for the poor, or 'regular' folks who simply can't afford to pay for various services.

What about the old?

The truth is that there are a MASSIVE number of elderly folks who require significantly more healthcare and attention than a regular joe who needs a single operation. These folks require ongoing attention and care, which means a regular ongoing expense for that care.

The truth is if everything were only private charities, there simply wouldn't be enough money JUST to pay for looking after old folks.

Even if they have retirement funds or pensions, quite often it simply isn't enough just to cover basic food and medicine expenses, thanks to inflation since the time they retired. And many of these people, toward the end, have to go to a home which has constant, 24/7 medical care- where an attendant checks in on you, bathes you, feeds and clothes you, moves you in and out of a wheelchair or other such implement, or at least turns you so you don't get bed-sores. I was in one of these homes this past weekend, visiting my grandmother who has dementia and is lucid for about 2 or 3 minutes before re-booting and starting all over again. If you're lucky, she'll remember your name and the fact that you're related. If not she gets quite upset if she doesn't remember you.

I'm not trying to pull on heart strings with a sob story, just trying to illustrate the fact that there are a massive number of elderly out there who simply aren't able to look after themselves, even when they worked hard their entire lives for a retirement or pension fund that simply isn't enough for any number of entirely valid reasons. So, what do we do? Do we turn them out on the streets in the hopes that private charities will look after them, or do we do the compassionate, humane thing and collectively cover the expense of taking care of someone who can't take care of themself?

That is the question!

Which means competition, which means customers, which means value and service at a better price.  I doubt your statement about "cheaper" for the very reason you cite and for the reason that you dont know the total cost of the service since it is built into a bloated government bureaucracy.

Well, I did a little googling for the cost of our medical health system. It has a mandatory insurance, and each health insurance company has to offer the same minimal coverage in one package so you can compare prices. That minimal package covers all basic health care needs and is determined by the government. For those who want more coverage the insurance companies offer additional packages. Every one has to pay for the basic package of course, but those who can't affort it can apply for subsidies. The basic insurance typically is something like $1500 a year for each adult, kids are free, and I guess that on average people pay something like $500 a year extra for better coverage.

I also looked up the total cost of healthcare for my country (the Netherlands), and for 2005 I found it was $6200 per person. This includes everything and about 20% of it is taken up by the care for the eldery and those with a handicap.

And although I'm not saying that our system is perfect (far from it), I do believe it shows that it is possible to have a decent, affordable socialized healthcare system with probably better service, for probably similar costs than the current US system.

And to go back on topic. Before WWII we didn't have a social system and people were dependent on charity. That gave charity a very bad name around here. It was demeaning for those who needed it, as everyone in your church would know you couldn't take care of yourself and your family. And yes, there was real poverty.

After WWII, with most pensioners deprived of all their savings, the government introduced a basic pension, giving some dignity back to the elderly. After that social welfare was gradually introduced in full, but it is no free lunch. The idea is that those who can work should work, and although far from being perfect, our government is doing a decent job in keeping the social welfare affordable.

And yes, this means that I give a lot less to charity than Brad, but I have more trust in our goverment when it comes to a proper handout of 'charity' than in most charity funds which spend fortunes on fund raising instead of the poor and the needy.

Really? What does the Dutch government when someone refuses to work? Let them starve? I doubt it.

No...

I didn't say the state had monopoly power. I said the state has monopsony power.

A monopsony is the opposite of a monopoly.

And it does cause prices to go down. That _IS_ the basic law of supply and demand.

If there are lots of consumers and only one supplier prices go up.

If there are lots of suppliers and only one consumer prices go down.

The latter is a monopsony. Monopsony power forces prices down just as monopoly power forces prices up. And that's why socialised healthcare is cheaper. There is no way around it.

That's one way of putting it. Another way is to say that it absolutely true. It's what the law of supply and demand dictates.

Of course. As I said before:

I stand by what I said.

I am sure they are. Nevertheless, if there were only one customer for hammers, government wouldn't even find a supplier willing to charge as much as $300 for one.

I disagree. There is no evidence that government is more corrupt and clueless than non-government entities. But there is a lot of evidence that government is more frugal and reliable.

Ideological statements like "the less the government is involved" make for a good catchphrase but are not even close to being any kind of solution for the problem, which is that some people cannot afford good healthcare. For them government involvement simply _is_ better than the alternative, and catchphrases won't change that simple fact and perception.

That picture only works if the sole consumer (government) would indeed pay very little. You are simultaneously assuming that the law of supply and demand will work (and suppliers will make little money and leave) and not work (and corruption will be rampant). In reality only one of the two happens; one in the one system, one in the other.

Note that corruption is merely a form of profit. Whether the money vanished in the government or in greedy suppliers with monopoly power (i.e. few suppliers many customers) is immaterial when comparing costs of the systems. The law of supply and demand tells us that the amount of money removed from the system as profit will be HIGHER in a private healthcare system. This means that whatever wealth an inefficient government will remove from the transaction will be less than the profit of healthcare providers in a private system. Neither are necessary for the system to work but will happen in the real world (i.e. there is no such thing as a 100% efficient customer or a perfectly selfless supplier).

You will be surprised to hear that either system has an advantage and a disadvantage. But socialised healthcare does not have both.

I grew up in a country that has socialised healthcare. I _know_ there are no waiting periods and that the stories told about these systems are lies. I have seen it work. You cannot convince me that it didn't.

Problem is it didn't work well enough. For someone with an income better than average private healthcare systems are better, financially. In Germany doctors are not making much money and the best move away. (And if you think that that is an excellent argument against socialised healthcare, you are correct; but it means that socialised healthcare is indeed cheaper than private healthcare.)

I personally prefer a mixed system: let the government become the only customer for everything necessary (thus creating monopsony power to keep prices low enough) and let a private system take care of speeding things up (thus creating demand for more expensive suppliers). This works very well in Ireland.

The thing with the $300 hammer and the $500 toilet seats wasn't that the individual items cost that much (the items themselves went for about market price).  The point was, when you add in all the extra bureaucratic overhead involved in procurring the hammers/toilet seats, the average price for the items on the contract where way out of proportion.

And that's what would happen with health care.  Yeah, they'd be able to say that a particular procedure costs less, or a particular pill costs less.  What you don't see?  All of the administration costs that are not specified.   When bidding on government contracts, each contracter has a rate they use to cover administration, costs and profit.  They multiply the base/average salary for a contracted position by this rate to get what they're actually going to put in the bid for the cost for that position (that's why my position's going for $95/hour and they pay me substantially less).  All of this gets wrapped into the overhead/administration costs that ARE going to be there.  No help for that.