[Bond]

Before I reply, I would like to point out one potential issue with this discussion:

Health care reform is a very wide and complex field. To debate something that broadly would be nearly impossible. I would suggest the scope of the discussion be limited.

So, before I answer your many questions, I would first like to explain a little more of my argument, if possible, using my previous three points:

1. Government intervention has historically raised health care costs, and will continue to do so if the government's role is increased (did you know that the government created today's insurance/HMO/PPO companies?).

Allow me to first use a few relevant and important statistical charts:



This chart depicts health care expenditures as percent of GDP and per capita. As you can see health care expenditures have nearly tripled as a percent of GDP since the 1960s, as well as the cost per capita of health care. This begs the question: what has lead to this enormous increase in the cost of health care?



This chart depicts average annual CPI change (%) by component. Once again we see the rise in medical care significantly outpacing the change of all other items. And, again, this begs the question, why?

For the answer to this question, I harkon back to my original point, that the rapid (and recent) rise in health care costs is primarily due to the advent of insurance/HMO/PPO companies, which were mandated by, and heavily regulated, by the government. In fact, the health insurance industry is perhaps the most heavily regulated industry in our country.

For an exact explanation of what HMO/PPO companies are and how they function, I would recommend outside sources, as I don’t want to go into too much detail concerning them. Suffice to say, they are a middle man, between you and your doctor. Middle men naturally raise the price of any good, as they have raised the price of health care.

Let’s consult one more chart, which depicts who is paying for health care costs:



Here again we see a stark contrast from the 1960s to present day. During the 1960s, the majority of health care was paid by out-of-pocket, and a small fraction was paid by the federal government. Present day, only a small fraction is paid by out-of-pocket, and payments by the federal government have quadrupled. I would, again, correlate this back to the rise of the HMO/PPO, as mandated by the federal government.

(These charts are derived from numbers provided by the Bureau of Labor Statistics.)

2. A single-payer system and/or an insurer of last resort is a flawed idea, as Medicaid and Medicare have both proved to be flawed programs.

There are many misconceptions surrounding programs such as Medicaid and Medicare. Let me use an example from Medicaid to explain this. Medicaid is the federal health program for low income families and individuals. Now, many assume that, when an individual enters a hospital and requires immediate surgery that the government pays fully for this procedure, as the individual is covered under Medicaid. This, is not so. The government pays a mere 40 cents on the dollar, and the hospital must pay the remaining 60 cents. The hospital is, in effect, paying for the hospital to perform the procedure. This extra cost, that the hospital must legally incur, is passed on to the hospital’s paying clients (those with private insurance). This, in turn, raises the rates of private insurance. Of specific note, is that private hospitals that are not religiously affiliated will often pass Medicaid customers off to religiously affiliated hospitals, as they know that those hospitals will not turn them down. As I hope you can see, this is a broken system for the hospital, and those who own private insurance. A single-payer / insurer of last resort system would logically function in a similar way, and be equally damaging.

3. We have no money left. Our treasuries are depleted.

This is perhaps the simplest of my three points. In an ideal world, where our government has a surplus of funds, a public option may make sense financially (although number one and two would still be an issue), but this is not the case. Our country has an enormous debt, a devalued currency, and overstretched empire. If there is one thing we simply cannot afford, it is public health care. Perhaps if we had saved more wisely as a country that would not be the case, but, it is not.

Please reference this chart (which shows personal savings as a percent of disposable personal income) to enforce my point:



(Source: Federal Reserve Statistical Release: Flow of Funds Accounts of the United States, Historical Data [1975-200])

Lastly, I should note the majority of my knowledge concerning this subject is derived from an internship that I had last summer at a Top 30 health care system.

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I will now try to address a few of your questions.

Originally Posted by TheGame

Bond would you say the current state of US's health care is better then countries that have adopted this system? I don't. So using historic results for something they have not directly tried doesn't hold much water. And it shows that its not a flawed idea.

I don't which one is "better." This seems to be your personal opinion on the matter. I would say they are different, but without evidence to support your claim, it is hard to reply.

I'd rather not compare this specific plan to other plans that are not the same thing. The overall model itself has shown to work.

Evidence? I would in fact introduce the opposite, reference England's National Health Service, which in 2006 had a deficit of around 500 million pounds.

Last numbers I heard, US is the country that pays the absolute most for healthcare per year, and has the 37th best coverage.

Source? What was the methodology for these ratings?

What would you propose we do to fix this system and change the results? (I only bolded because I'm curious about this and don't want it overlooked.)

Generally speaking, I would advocate a return to less government intervention, when more payments for health care were made out-of-pocket. This would proportionatly decrease the cost that the individual pays for health care, as government intervention in industries inherently raises prices. I do not have a more specific proposal, as I have not given this issue the adequate amount of research it would deserve.

Would you really be shocked if their system yielded bad results?

Not entirely sure who the pronoun "their" refers to. If you are referring to the public option, then no, I would not be shocked if it yielded bad results.