Healthcare

[berbatrick]

@Mike Schatner

Regarding the poll about "satisfaction with your healthcare system" which is high in the US - this indicates an important point:

Spoiler

Despite these low levels of satisfaction with the healthcare system in general, the majority of Americans report being “very” or “completely” satisfied with the most recent care they received in either a medical clinic or a hospital, a satisfaction which beat out all of but two of the countries listed in the above figure:

Spoiler

https://www.forbes.com/sites/peteru...eir-healthcare-system-heres-why/#7ac3173394fe

 

[Raoul]

Correct, the democrats do not believe in this. It's not a coincidence that Republicans hold all three branches of government, 34 governerships and 32 state legislatures.

The only thing that will change the party's mind is a massive blue wave this fall and a new round of internal polling that informs them they can be more assertive on healthcare - much as what happened with Gay marriage in 2008-10 when Obama went from sympathetic but non-commital to eventually wholeheartedly for it after realizing the tide had turned and public sentiment had shifted dramatically.

 

[Eboue]

Why couldn‘t you come to UHC by fixing ACA? Strenghten the indicidual mandate (no opting out, govt pays for those who can‘t afford it) and oblige insurers by law to provide all necessary treatments in those mandated plans and you‘re basically there or what is missing? Cost would obvs. still be an issue that needs to be dealt with seperately with other measures.

because you need to create constituencies who will consistently turn out to vote for these programs. medicare and social security are massively popular because they are simple for people to understand and easy to use.

obamacare was a pain in the ass to use that required you to use a spreadsheet to compare deductibles and premiums and lifetime limits and in network / out of network costs and bronze vs platinum vs whatever and read through hundred page booklets of fine print to make sure you arent getting screwed by an insurance company and when that didnt work you had to navigate a phone tree and press 8 different buttons to talk to an actual person. and in the end people still had pretty shitty insurance where the costs rose year of year and vast areas of the country had 0 or 1 companies actually servicing the area.

so when it came time to actually defend it at the ballot box people were not interested. they couldnt explain it to their friends and families and they werent invested in keeping it around. single payer is easy to understand and easy to use. it will build its own base of voters who will come out on election day to save the program that prevented them from losing their house because they got sick or having to choose between food and medicine or getting an uber for their kid to go to the hospital because they couldnt afford a $700 ambulance bill. give people something that makes their lives better and make it easy for them to understand how and they will fight for it.

 

[Mike Schatner]

@Mike Schatner

Regarding the poll about "satisfaction with your healthcare system" which is high in the US - this indicates an important point:

Spoiler

You actually inadvertently highlighted a point that a lot of people overlook with that. 30% of the uninsured are happy with the current system, which is staggering.

 

[berbatrick]

The only thing that will change the party's mind is a massive blue wave this fall and a new round of internal polling that informs them they can be more assertive on healthcare - much as what happened with Gay marriage in 2008-10 when Obama went from sympathetic but non-commital to eventually wholeheartedly for it after realizing the tide had turned and public sentiment had shifted dramatically.

I think the more comfortable the margin in 2018, the less the chances of radical change in 2020. It will embolden the DCCC and centrists who have had to lay (slightly) low after the 2016 debacle.

 

[berbatrick]

You actually inadvertently highlighted a point that a lot of people overlook with that. 30% of the uninsured are happy with the current system, which is staggering.

And 70% aren't, and many people insured are also in favour of govt healthcare, which is a huge constituency that can be mobilised politically.

 

[Eboue]

The only thing that will change the party's mind is a massive blue wave this fall and a new round of internal polling that informs them they can be more assertive on healthcare - much as what happened with Gay marriage in 2008-10 when Obama went from sympathetic but non-commital to eventually wholeheartedly for it after realizing the tide had turned and public sentiment had shifted dramatically.

the reason obama and clinton and most centrist dems were able to "evolve" on gay marriage because the left kept pressure on them and eventually public opinion changed. thats what will happen with single payer. but it wont happen if the lefts goal is only for incremental improvements to the aca. it will happen if we demand that every democrat who wants support of the left (and a burgeoning base of supporters) is to back single payer.

 

[langster]

So as always seems to be the case with the NHS we've been given the choice for my 83 year old grandfather to have a catheter for 6 months or pay £7k and get a TURP procedure privately within 5 working days. As seems to always be the case in this country; you pay through the nose in taxation for a mediocre government run service and if you want decent service you have to pay again. Whether it's education, health, transport or social care.

Funny that people wax lyrical about how great the NHS is, but anyone who can afford private healthcare does so quicker than you can say "unacceptable waiting time".

The NHS saved my life. As is well know on this site I had a brain haemorrhage. I would and should be dead but the NHS saved my life and I had a weeks stay in hospital that I cannot fault whatsoever. Without insurance i have been told my operation and treatment would have cost well over £300,000. My dad had a double heart attack at Christmas and it saved his life too. People want and expect everything straight away with the NHS and that pisses me off tbh. It's free, it should be appreciated and having to wait a short amount of time although uncomfortable as it may be, I think is a price worth paying for top class FREE health care.

 

[Raoul]

I think the more comfortable the margin in 2018, the less the chances of radical change in 2020. It will embolden the DCCC and centrists who have had to lay (slightly) low after the 2016 debacle.

As long as Perez is in charge, he is likely to take a more pragmatic position on policies that can get them back in control of congress and the WH. He is after all a more pragmatic Obama acolyte and likely still gets advice from him on various issues. Therefore it will be up to the voters this fall to send a message to the Dem party as to what they want. If a slew of new pro-single payer Dems get elected then Perez will interpret that as favorable to shifting the platform in that direction. Much will also be informed by who emerges as the Dem nominee in 2019 and 2020 - that person's political views on a variety of topics will obviously weigh heavily into what the party's official convention platform is.

 

[Mike Schatner]

The NHS saved my life. As is well know on this site I had a brain haemorrhage. I would and should be dead but the NHS saved my life and I had a weeks stay in hospital that I cannot fault whatsoever. Without insurance i have been told my operation and treatment would have cost well over £300,000. My dad had a double heart attack at Christmas and it saved his life too. People want and expect everything straight away with the NHS and that pisses me off tbh. It's free, it should be appreciated and having to wait a short amount of time although uncomfortable as it may be, I think is a price worth paying for top class FREE health care.

The NHS saved my life as well. My nephews incident on the previous page would have costs over a million. Its a great institution that should be cherished and protected, and properly funded.

 

[Javi]

I agree that ACA should be fixed. the individual mandate is too lax and that is one of the main drivers of inflating premiums. Tighten that up, bring premiums down to where they were originally conceptualized to be, and the system would be significantly better. That is where it seems Tom Perez and the Dems are going. Single Payer can still be done down the road, but i don't get the impression the Dems believe it is feasible in the present, otherwise they would've already made it a central part of their platform.

My point is that ACA with those fixes I proposed is basically single payer. So unless your point is that the problem is either a.) that the dems said they don't want those fixes or b.) that it's bad from a campaigning point of view to not adopt single payer rhetoric I'm not following.

because you need to create constituencies who will consistently turn out to vote for these programs. medicare and social security are massively popular because they are simple for people to understand and easy to use.

obamacare was a pain in the ass to use that required you to use a spreadsheet to compare deductibles and premiums and lifetime limits and in network / out of network costs and bronze vs platinum vs whatever and read through hundred page booklets of fine print to make sure you arent getting screwed by an insurance company and when that didnt work you had to navigate a phone tree and press 8 different buttons to talk to an actual person. and in the end people still had pretty shitty insurance where the costs rose year of year and vast areas of the country had 0 or 1 companies actually servicing the area.

so when it came time to actually defend it at the ballot box people were not interested. they couldnt explain it to their friends and families and they werent invested in keeping it around. single payer is easy to understand and easy to use. it will build its own base of voters who will come out on election day to save the program that prevented them from losing their house because they got sick or having to choose between food and medicine or getting an uber for their kid to go to the hospital because they couldnt afford a $700 ambulance bill. give people something that makes their lives better and make it easy for them to understand how and they will fight for it.

I totally understand your argument that single payer done through this way of coalition building is very strong against opposing political rhetoric and for that reason would agree that it's the best way to do it.

The problems you mention in your second paragraph could imo be handled by a strong regulating agency and additionally public education and comparison institutes.

So in essence I'm saying it could be achieved through another way also and if costs can be successfully handled I predict it to be stable enough to endure and eventually become of similar importance like pensions for instances. But let me repeat, I think your way of going about it is preferable too.

 

[langster]

The NHS saved my life as well. .

feck. I knew it was flawed. Take everything I said back.

 

[Mike Schatner]

feck. I knew it was flawed. Take everything I said back.

 

[Raoul]

My point is that ACA with those fixes I proposed is basically single payer. So unless your point is that the problem is either a.) that the dems said they don't want those fixes or b.) that it's bad from a campaigning point of view to not adopt single payer rhetoric I'm not following.

Yes, what you described would be close to a single payer system. It may therefore be more beneficial for the Dems to run on a "Improve the ACA" platform, which would be something that would be tangibly implementable - as opposed to run yet again on a complete overhaul of a system they themselves only implemented a decade ago. The biggest problem has been premiums, so if they can fix that then a much larger swath of the population would be content with their healthcare.

 

[Eboue]

Yes, what you described would be close to a single payer system. It may therefore be more beneficial for the Dems to run on a "Improve the ACA" platform, which would be something that would be tangibly implementable - as opposed to run yet again on a complete overhaul of a system they themselves only implemented a decade ago. The biggest problem has been premiums, so if they can fix that then a much larger swath of the population would be content with their healthcare.

That's literally what Hillary Clinton ran on.

 

[Raoul]

That's literally what Hillary Clinton ran on.

She had other problems than just her healthcare position.

 

[Mike Schatner]

The ACA was a poorly conceived idea. Forcing people to buy insurance they don't want or can't afford and punishing them if they refuse.......I mean what could go wrong. Then you are relying on the States and insurance companies to make it work....nothing wrong with that picture.

Bernie is at least on the right path. It probably needs to be phased in fixing the main issues and the funding I have seen is less than bullet proof but its a decent plan.

 

[Grinner]

That poll about healthcare satisfaction should really ask the question that ought to be on everybody's mind. "Are you satisfied with the healthcare that everybody else gets." I quite like the healthcare that I get because I rarely need it and I get great coverage through my wife's state job. But, it sickens me that people in this country can die or go bankrupt because they can't get the care that they need. But I think that is the difference between Brits and Americans (massive generalization, I know), that they care about care for all rather than just what they can personally get.

I'd like to see those healthcare events that occur in big cities, where poor people queue for days to get care from professionals who donate their own time and give it for free, like what you would see in a third world country, covered extensively on the news so that everybody else can see just how dire it is if you are poor. We need more fecking empathy in this country and that goes for all issues, not just healthcare but guns, wages, college costs etc. I noticed that people in England still give a shit about others, it's less obvious over here though.

 

[Mike Schatner]

That poll about healthcare satisfaction should really ask the question that ought to be on everybody's mind. "Are you satisfied with the healthcare that everybody else gets." I quite like the healthcare that I get because I rarely need it and I get great coverage through my wife's state job. But, it sickens me that people in this country can die or go bankrupt because they can't get the care that they need. But I think that is the difference between Brits and Americans (massive generalization, I know), that they care about care for all rather than just what they can personally get.

I'd like to see those healthcare events that occur in big cities, where poor people queue for days to get care from professionals who donate their own time and give it for free, like what you would see in a third world country, covered extensively on the news so that everybody else can see just how dire it is if you are poor. We need more fecking empathy in this country and that goes for all issues, not just healthcare but guns, wages, college costs etc. I noticed that people in England still give a shit about others, it's less obvious over here though.

Its definitely different. The thing I find it hard to fathom is a lot of Americans are deeply religious and believe in the word of Jesus. Yet they turn there back on their fellow citizens when it suits them.

 

[Cpt Negative]

I’m not a fan of private healthcare but the UK system cannot continue as it is in the current climate.

The split is so heavily weighted towards physical health, but there will be a paradigm shift to mental over the next few years and that will bring a whole host of costs to an ever increasing bill and the current one is over spending massively as it is.

The only way I can see the NHS existing anywhere near its current state is to either

A) add 1p in the pound to tax that is dedicated to the NHS. I actually don’t think many would mind paying this knowing the service they receive. Add a £5 charge to see a Dr, this will be like the plastic bag charge in the UK.

Too many people go to the Drs with coughs and colds when there’s no real reason too.

B) go a bit more radical and actually start charging people who waste the NHS time. If you get pissed and break your leg, you should have a responsibility to pay for it, not rely on others because of your antics.

You can either stop people going or throw more money at it but neither will happen any time soon

 

[Grinner]

I'm back and forth on that small charge to see a doctor.

 

[Billy Blaggs]

Its definitely different. The thing I find it hard to fathom is a lot of Americans are deeply religious and believe in the word of Jesus. Yet they turn there back on their fellow citizens when it suits them.

You've met my parents then?

 

[Cpt Negative]

I'm back and forth on that small charge to see a doctor.

Perhaps you only pay it the Dr deems your appointment was a waste of time and could have been dealt with by a Pharmacist etc

 

[Sweet Square]

I’m not a fan of private healthcare but the UK system cannot continue as it is in the current climate.

The split is so heavily weighted towards physical health, but there will be a paradigm shift to mental over the next few years and that will bring a whole host of costs to an ever increasing bill and the current one is over spending massively as it is.

The only way I can see the NHS existing anywhere near its current state is to either

A) add 1p in the pound to tax that is dedicated to the NHS. I actually don’t think many would mind paying this knowing the service they receive. Add a £5 charge to see a Dr, this will be like the plastic bag charge in the UK.

Too many people go to the Drs with coughs and colds when there’s no real reason too.

B) go a bit more radical and actually start charging people who waste the NHS time. If you get pissed and break your leg, you should have a responsibility to pay for it, not rely on others because of your antics.

You can either stop people going or throw more money at it but neither will happen any time soon

So your great plan to save the NHS is to get rid of the NHS.

 

[Grinner]

Perhaps you only pay it the Dr deems your appointment was a waste of time and could have been dealt with by a Pharmacist etc

Don't ask NHS docs to be cnuts.

 

[Cpt Negative]

So your great plan to save the NHS is to get rid of the NHS.

Not at all, how is increasing taxes to pay for it getting rid?

 

[esmufc07]

I’m not a fan of private healthcare but the UK system cannot continue as it is in the current climate.

The split is so heavily weighted towards physical health, but there will be a paradigm shift to mental over the next few years and that will bring a whole host of costs to an ever increasing bill and the current one is over spending massively as it is.

The only way I can see the NHS existing anywhere near its current state is to either

A) add 1p in the pound to tax that is dedicated to the NHS. I actually don’t think many would mind paying this knowing the service they receive. Add a £5 charge to see a Dr, this will be like the plastic bag charge in the UK.

Too many people go to the Drs with coughs and colds when there’s no real reason too.

B) go a bit more radical and actually start charging people who waste the NHS time. If you get pissed and break your leg, you should have a responsibility to pay for it, not rely on others because of your antics.

You can either stop people going or throw more money at it but neither will happen any time soon

Perhaps the Government of the last seven years shouldn't have slashed social care budgets and underfunded the NHS.

Give it the money it needs, we can afford it and we spend less on the NHS as a % of our GDP as many European countries (around 9% versus 11%).

 

[esmufc07]

I’m not a fan of private healthcare but the UK system cannot continue as it is in the current climate.

The split is so heavily weighted towards physical health, but there will be a paradigm shift to mental over the next few years and that will bring a whole host of costs to an ever increasing bill and the current one is over spending massively as it is.

The only way I can see the NHS existing anywhere near its current state is to either

A) add 1p in the pound to tax that is dedicated to the NHS. I actually don’t think many would mind paying this knowing the service they receive. Add a £5 charge to see a Dr, this will be like the plastic bag charge in the UK.

Too many people go to the Drs with coughs and colds when there’s no real reason too.

B) go a bit more radical and actually start charging people who waste the NHS time. If you get pissed and break your leg, you should have a responsibility to pay for it, not rely on others because of your antics.

You can either stop people going or throw more money at it but neither will happen any time soon

Also there is a lot of support for a hypothecated tax for the NHS. I am completely against charging to see a Doctor. That would adversely affect the most vulnerable in our society and really would not raise a lot of money anyway.

 

[Javi]

Also there is a lot of support for a hypothecated tax for the NHS. I am completely against charging to see a Doctor. That would adversely affect the most vulnerable in our society and really would not raise a lot of money anyway.

It probably wouldn't be about raising money but about creating financial incentive to not go and see your GP when getting hit by a mosquito. Obviously those who won't be able to afford this charge should get money from the government to cover it.

 

[esmufc07]

It probably wouldn't be about raising money but about creating financial incentive to not go and see your GP when getting hit by a mosquito. Obviously those who won't be able to afford this charge should get money from the government to cover it.

The money needed to set up stuff like this probably wouldn't even cover the minuscule amount it would raise. Germany tried it a few years back IIRC and deemed it a waste of time. Plus what if someone didn't have money on them, refuse them permission to see a doctor? It's absurd.

Educate people more, yes. I'd imagine there's a lot of frustration with GPs about some of the things patients come in for. As soon as we start charging for GPs appointments though we're going down a slippery path.

 

[Javi]

The money needed to set up stuff like this probably wouldn't even cover the minuscule amount it would raise. Germany tried it a few years back IIRC and deemed it a waste of time. Plus what if someone didn't have money on them, refuse them permission to see a doctor? It's absurd.

Educate people more, yes. I'd imagine there's a lot of frustration with GPs about some of the things patients come in for. As soon as we start charging for GPs appointments though we're going down a slippery path.

No need to bring money with you, it's all about knowing the consequences in an incentive scheme. Just bill them afterwards. Don't know the details of the german system though.

 

[SirAF]

I’m not a fan of private healthcare but the UK system cannot continue as it is in the current climate.

The split is so heavily weighted towards physical health, but there will be a paradigm shift to mental over the next few years and that will bring a whole host of costs to an ever increasing bill and the current one is over spending massively as it is.

The only way I can see the NHS existing anywhere near its current state is to either

A) add 1p in the pound to tax that is dedicated to the NHS. I actually don’t think many would mind paying this knowing the service they receive. Add a £5 charge to see a Dr, this will be like the plastic bag charge in the UK.

Too many people go to the Drs with coughs and colds when there’s no real reason too.

B) go a bit more radical and actually start charging people who waste the NHS time. If you get pissed and break your leg, you should have a responsibility to pay for it, not rely on others because of your antics.

You can either stop people going or throw more money at it but neither will happen any time soon

That's absolutely true, I'm almost scared to go to the doctors office because there will always be some moron (Doesn't apply to young children or the elderly obviously) with a cold who doesn't need to be there, spreading their germs around

Still, you can't charge people more "just" to get rid of that problem. I strongly believe that every civilized country should provide "free" healthcare.

Slightly off topic: The goverment in Norway recently decided to lower the percentage of absence allowed for high school students - ie you would need a doctor's note for something as mundane as the common cold to avoid being marked as "absent" which in turn has resulted in a surge of high school kids going to their GP to get a note just for a cold.

 

[Carolina Red]

ie you would need a doctor's note for something as mundane as the common cold to avoid being marked as "absent"

We do that too.

 

[SirAF]

We do that too.

Interesting! Is there a certain percentage of absence that is allowed? Here you are allowed 10% of "undocumented absence".

 

[Carolina Red]

Interesting! Is there a certain percentage of absence that is allowed? Here you are allowed 10% of "undocumented absence".

It’s around 5% for us.

45 day class = 3 unexcused allowed
90 day class = 5 unexcused allowed
180 day class = 10 unexcused allowed

If your unexcused absences go over that threshold, you have to make up seat time on Saturdays until the overage is erased or you don’t get credit for the course.

 

[SirAF]

It’s around 5% for us.

45 day class = 3 unexcused allowed
90 day class = 5 unexcused allowed
180 day class = 10 unexcused allowed

If your unexcused absences go over that threshold, you have to make up seat time on Saturdays until the overage is erased or you don’t get credit for the course.

Thanks.

 

[nimic]

Slightly off topic: The goverment in Norway recently decided to lower the percentage of absence allowed for high school students - ie you would need a doctor's note for something as mundane as the common cold to avoid being marked as "absent" which in turn has resulted in a surge of high school kids going to their GP to get a note just for a cold.

It has also resulted in a very large decrease in absence, incidentally.

 

[SirAF]

It has also resulted in a very large decrease in absence, incidentally.

Oh yes, it wasn't a slight on the new regulations.

 

[Sweet Square]

Not at all, how is increasing taxes to pay for it getting rid?

The NHS is suppose to be a universal, free at the point use heath care. Charging people for missed appointments(Which firstly will only hurt the most vulnerable people in the country and won't bring enough money to solve the problems of the NHS) or this

B) go a bit more radical and actually start charging people who waste the NHS time. If you get pissed and break your leg, you should have a responsibility to pay for it, not rely on others because of your antics.

completely against what the NHS is.

Yes of course tax people more(And kick out of all the privatisation) but there is a way to do that doesn't go against the ideas of the NHS.

 

[Mozza]

No need to bring money with you, it's all about knowing the consequences in an incentive scheme. Just bill them afterwards. Don't know the details of the german system though.

What if they can't pay?