Until Midterm Elections...

Scott versus Scott

Welcome to our blog. Here we will debate the days most serious topics and allow users the chance to discuss the topics as well. The range of topics will vary, but one thing will remain certain, the debate will rage on. Scott Lesinski is a proud conservative and Scott Jones is a proud liberal. However, the roles will switch on some topics. Stay tuned.

Scott Lesinski is currently an actuarial associate for a large human resources and insurance consulting firm in Saint Louis. He is also an avid student of US history and enjoys following current events, with an eye to their contextual relationship to the past. He is also, in fact, a former student of Mr. Scott Jones. Scott is working toward his FSA credentials, which is akin to earning a PHD in Actuarial Science.

Scott Jones is currently a high school social studies teacher at a high school in suburban St. Louis, MO. He teaches World History, AP American Government and Senior American Foreign Policy. He has a BS. Ed. (Secondary Social Studies) from the University of Missouri - Columbia and a M.A. (History) from Southeast Missouri State University. He is currently working on a dissertation in character education to earn a Ph.D. in Educational Psychology.

Thursday, September 3, 2009

Is it as bad as Conservatives say it is? NO!!

I posted this as a comment, but I think it is important enough to put in as a main topic. We are being faced with too many lies from conservatives about what nationalized medicine looks like in other countries. If it was as bad as the conservative liars say it is, it wouldn't be as popular as it actually is.

Scott - since you love posting links for articles that support your unsubstantiated views on the UK and Canada health care systems, here's mine.

http://www.stltoday.com/stltoday/news/stories.nsf/editorialcommentary/story/348F52DE319AF4DC86257623007FAAEB?OpenDocument

The British, French, Irish, Finnish, Swedes, Swiss, Germans, Italians,etc love their national health care program. Conservatives like to point out the small minority of problems with the European model of health care, but these are simply not true of the overall picture of these systems.I've been in constant contact with friends from Europe and they are appalled at the conservative attacks on their system. Sure, they argue all the time about what should be covered, but they never argue about the overall program. They love it and are very happy with it.This link explains the lies of conservatives concerning the British National Health Service from the British perspective.

http://www.salon.com/politics/war_room/2009/08/14/british_nhs/index.html

A recent Harris poll found the following information about the overall happiness Europeans have with their health care. The numbers below represent that total percentage of people that were at least happy with the system and felt only minor changes were needed (the numbers in parenthesis are people who were completely happy with the system and felt absolutely no changes were necessary)

France: 78% (29%)
Netherlands: 91% (42%)
Canada: 86% (26%)
Spain: 83% (22%)
UK: 76% (26%)
Italy: 77% (22%)
Germany: 77% (19%)

These overwhelming majorities indicate a strong satisfaction with the sytem. Many people who indicated some minor changes were needed consider them minor and not worthy of a system overhaul.

Furthermore, the following information from the Harris poll shows the following percentage of people in each country who believe their health care system is the best in the world. (Not as much data was available here.)

UK - 59%
France - 70%
Germany - 32% (Most envious of the Netherland system)
Italy - 28% - (Most envious of the French system)
The Netherlands - 86%

The most interesting fact in this category is that NONE of the Europeans were envious of our system.

The same poll found that 69% of British believe the National Health Service is a fundamental program that is necessary for the maintaining of the high standard of living in Britain and that everything must be done to maintain the service. Both of the main political parties (Conservative and Labor) in Britain support the NHS and discuss only changes to bring better service to the people.

I don't think these numbers indicate the same irrational fear that conservatives are attempting to ram down the minds of Americans.

This is understandable since the truth doesn't support their position.

17 comments:

  1. "The quality of health care in America is the best in the world," Senator John McCain said.

    It has become an increasingly familiar refrain, and no wonder. It appeals to patriotic audiences and implies that reform — tinkering with what purportedly is the best system — would be dangerous and unnecessary.

    So it seems almost subversive to ask this simple question: Is it true? Is U.S. health care the world's best?

    The short answer: No.

    It does well on some quality measures, not so well on many others.

    Study after study has found quality problems in U.S. health care.

    Here's what experts from the Institute of Medicine, part of the National Academies of Science, wrote in a 2001 report: "The American health care delivery system is in need of fundamental change.... Health care today harms too frequently and routinely fails to deliver its promised benefits."

    Individual American physicians often are outstanding. But the system in which they practice is fragmented and uncoordinated, filled with misdirected economic incentives and surprisingly lacking in basic care management tools.

    The result: Even people with good insurance get recommended treatments only about half the time. Meanwhile, medical errors kill more Americans each year than breast cancer, AIDS or motor vehicle accidents.

    No health system is perfect. Other countries have problems, too. But many researchers have compared U.S. health care to that in other developed countries and made similar conclusions.

    A new analysis by experts from the non-partisan Urban Institute concludes: "It is safe to say that U.S. health care is not pre-eminent on quality."

    Where does it stand out? "(I)n the very high costs of its health care and the share of its population that are uninsured."

    In a ground-breaking report published nine years ago, the World Health Organization compared the health systems of 191 nations. It ranked the United States at number 37.

    That report isn't based strictly on quality measurements. Instead, it compares actual performance against what health experts say could be accomplished with the resources spent on care.

    The poor performance of our health care system is reflected in quality indicators that have become distressingly familiar in the reform debate.

    — Average life expectancy is lower here than in most other developed nations. Infant mortality is significantly higher.

    — We have the highest rate of preventable deaths among 19 industrialized nations in a recent study. That rate has declined in recent years, but not as much as it has elsewhere.

    — A survey of doctors in five countries found American physicians are more likely to say cost controls threaten the quality of care they provide, and to complain about limitations on medications that they can prescribe.

    — American patients — especially those with chronic illnesses — are far more likely than those in other countries to report skipping medicine or missing doctor visits because of cost.

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  2. Good news: We do very well on cancer care. The United States has a higher five-year survival rate for many cancers than most other countries.

    The implication, at least in the minds of many reform opponents, is that means we have the latest, most technologically advanced treatments. But experts say the better survival rate is almost entirely because of more aggressive cancer screening here.

    U.S. women are more likely to have annual mammograms than women in most other countries. Men are more likely to be screened for prostate cancer.

    Screening helps catch cancer earlier, when it's easier to treat. It also helps catch some cancers that never would become life threatening and require treatment. That increases the survival rate.

    Those achievements must be balanced against the fact that about 50 million Americans are uninsured and have limited access to care. Millions more are underinsured and face the threat of bankruptcy should they become seriously ill.

    Among other developed nations, only Mexico and Turkey have such large proportions of uninsured residents. None has a similar rate of medical bankruptcy.

    Here are some interesting statistics:

    — Survival rates for U.S. cancer patients under age 45 are similar to those in Europe, but cancer patients 65 and older do much better than those in Europe.

    — Average U.S. life expectancy at birth is low, but average life expectancy at age 65 is better here than in Europe.

    — And while childhood vaccination rates are lower in the United States than in Europe, the rate of elderly Americans who receive annual flu shots is substantially higher.

    Why do health outcomes for Americans get better when they hit 65? Because that's when they qualify for Medicare. Many get health insurance for the first time.

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  3. Of course, the familiar refrain from conservatives is that when the government gets involved, things get worse.

    Funny how the facts, AGAIN, don't seem to support the lies from the political right.

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  4. Polls in America have found that patients and doctors want a universal single payer plan.

    http://www.reuters.com/article/latestCrisis/idUSN31432035

    http://www.consumerwatchdog.org/resources/PollMemo.pdf

    Recently, those numbers have declined as Republican lies about natioanized health care have increased.

    I think I remember Scott L. complaining about the dupability of the American people when it came to President Obama. I guess dupability isn't a problem when it benefits you.

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  5. Alright, I took the weekend off from the blog and spent some much needed time relaxing and studying some other stuff...remember I am pursuing my actuarial credentials and an exam thus approacheth.

    I never got around to responding to your Harris Survey. Lets think about this for a bit. In my very original healthcare post a while back, I pointed out that Americans, very much like their European counterparts, LIKE their healthcare. 83% of respondents like their care. 75ish% like their insurance. So those are not exactly bad comparisons to the Harris study you cite. We could get into the reasons for this data, but I really think they miss the forest for the trees.

    "The same poll found that 69% of British believe the National Health Service is a fundamental program that is necessary for the maintaining of the high standard of living in Britain and that everything must be done to maintain the service. Both of the main political parties (Conservative and Labor) in Britain support the NHS and discuss only changes to bring better service to the people."

    There are lots of underlying reasons for this statement. First, roughly 1 in 6 Britons have never worked. Their welfare state and that entitlement mentality is so very much more prevalent there than here.

    As to both parties supporting the NHS...Scott, critical thinking. You just said that nearly 70% of the population really wants to keep their "free" healthcare. You think ANY politician would declare himself an opponent to something so popular? Mark Steyn, conservative Canadian writer, points out that right now, we in America can argue about the merits of giving over our healthcare to the government or not. We have the option to say, hmmm, is this something that will be good for us as individuals, will it be affordable? Etc Etc. But, as he points out and your statement confirms, once we get national healthcare, that will become THE focus of national politics in every election. Neither party will talk about really fixing the problems, there will just be a constant drumbeat from either side over who can manage this financial and humanitarian boondoggle better.

    Healthcare is ballgame. That is where we go from a free, capitalist nation, over the edge and become a socialist democracy, like the rest of Western Europe and Canada

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  6. "Meanwhile, medical errors kill more Americans each year than breast cancer, AIDS or motor vehicle accidents."

    What about medical denials that take place in Canada, the UK, et al? You know in Canada this year, the budget guys up there decided to cut elective surgeries by 15%. What counts as elective? Its not what you think of as elective in America, like a nose job or liposuction. No, knee replacement is "elective". Basically, you can elect to have that needed surgery but the government can "elect" not to give it to you if they don't have the money. You get no alternative except to drive to the US and pay out of pocket.

    "— Average life expectancy is lower here than in most other developed nations. Infant mortality is significantly higher."

    Please stop using this as the preeminent measure of quality. Infant mortality in the US is about 5.5 deaths per 1000 live births. Tops on the list is about 2.6 per 1000. Given the higher level of riskiness we accept with the babies we deliver and the total wide open definition of what constitutes a "live birth" I'd say that we are doing pretty well.

    I went into a very detail, statistical analysis of why life expectancy at birth is a horrible comparison of different countries' healthcare systems. Did you read that at all?

    "— We have the highest rate of preventable deaths among 19 industrialized nations in a recent study. That rate has declined in recent years, but not as much as it has elsewhere."

    Where is the data and study results for this, i'd like to see what they are measuring.

    "— A survey of doctors in five countries found American physicians are more likely to say cost controls threaten the quality of care they provide, and to complain about limitations on medications that they can prescribe."

    Well duh! We DO have they highest quality technology. We have the best pharmaceutical companies doing the best, and yes very expensive, research and development around. That costs more. Other countries don't complain as much because they don't have the options we do.

    "— American patients — especially those with chronic illnesses — are far more likely than those in other countries to report skipping medicine or missing doctor visits because of cost."

    And this will be so different when the government gets to decide whether we even get the access or not.

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  7. "Those achievements must be balanced against the fact that about 50 million Americans are uninsured and have limited access to care. Millions more are underinsured and face the threat of bankruptcy should they become seriously ill."

    This number is pure bunk. 12-15 million of this number are illegal aliens. Not. My. Problem.

    Another 10 million or so make above $50,000. Give up the cable TV, sell your car and invest in a clunker, cut other nonessential costs. Healthcare is about life, so it ought to take more priority in our expenses.

    Yet another 10 million or so qualify for Medicaid. But apparently, medicaid is SO FANTASTIC that those people decided not to enroll.

    Another 10 million or so are people like me, young, healthy, 20-30 somethings who don't want to pay $300 a month so they can be insured against every thing under the sun mandated by whatever state they live in. This bunch could be freed up to pay for HDHP with HSAs like I have and they would probably take it. I pay about $120 per year for basic catastrophic health insurance. That policy needs to be available to this demographic, but thanks to politicians mandating so many rules on the insurance industry, such coverage is very difficul to acquire.

    There is some overlap among these groups. We are left with about 12 million folks who really are in a pinch. If we really cared about insuring them, why not divert $30 billion of the wildly successful stimulus package (ahem) and buy them policies?

    Scott, does any of what I just wrote sound like fear mongering to you? Or lies? Please, if there are such points, I'd like you to point out specifically what I said that I lied about.

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  8. "Here are some interesting statistics:

    — Survival rates for U.S. cancer patients under age 45 are similar to those in Europe, but cancer patients 65 and older do much better than those in Europe."

    In the US, if you are a 70 year old woman and you get breast cancer, you get treated. In the UK, they wish you the best of luck.

    "— Average U.S. life expectancy at birth is low, but average life expectancy at age 65 is better here than in Europe."

    Not much lower, and again, not a good indicator of healthcare system quality.

    "— And while childhood vaccination rates are lower in the United States than in Europe, the rate of elderly Americans who receive annual flu shots is substantially higher."

    We have some parents in the US who have bought into the notion that vaccinating your child will give him/her autism. Its not true, but as long as that percentage remains low enough, we are not at any real risk of allowing polio back into the game.

    65 year olds can walk into Barnes Hospital today and get a flu shot for free. And I do mean today, like literally September 8, 2009. You can too. Free of charge.

    "Why do health outcomes for Americans get better when they hit 65? Because that's when they qualify for Medicare. Many get health insurance for the first time."

    First off, this is ridiculously brash and broad stroke. Americans over 65 do better than their European counterparts. What gives? I thought European health care was better than ours?

    Moreover, in reality, again, the difference in conditional life expectancy once you've hit 65 does not really vary a whole lot among western nations. That's because life expectancy, as I've pointed out, has much more to do with life style and genetics than healthcare. While Americans over 65 do survive dread disease a lot better here than in Europe and Canada, the aggregate life expectancy is not what you should look at. Look at survival rates and wait lines and access.

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  9. I'm going to bring up another side of this debate that we have not been discussing: Cost.

    The CBO estimated that HR 3200 would add about $1.6 trillion to the federal debt in 10 years.

    Just today Congress is debating raising the debt ceiling above $12 trillion, because we are going to pass that up by mid October of THIS YEAR.

    When are we, as a nation, going to realize that money is not free and that we can't keep this deficit spending up forever? On Drudge today, headline about the Chinese wanting to go to a single global currency. Apparently, they're not too happy with the rate at which we are printing money and devaluing their investment. Not to mention, they'd have to be complete idiots to think that this administration intends to ever pay them back.

    Look it, Scott and others. Conservatives are not in favor of the status quo. We are not being financed by insurance companies or Fox News. We are not saying that our system is perfect. I have acknowledged that fact many times and I get nary a response from the liberals on this post. Apparently, only government has the ability to save us from our healthcare woes.

    I say no. There is another option. A better one. Freedom is that option. Here is my (and many other republicans and conservatives') proposals for real healthcare reform in America.

    1. Eliminate state mandated coverages. Allow a true insurance marketplace to develop in which consumers of care actually decide what they are willing to pay for and what they want insured.

    2. Open up interstate trade of insurance. This follows the elimination of mandated coverage.

    3. Allow small businesses to pool together and form insurance co-ops whereby they will be able to pool risk and get lower rates like the bigger employers. This follows the interstate trade opening up. A small business owner in California recently pointed out that there are 1,300 insurance companies in America, but that she had access to 6 of them in California, where she has her business.

    4. Institute tort reform to limit punitive damage claims that may be awarded in malpractice lawsuits. Also, consider a "loser pays" system that would favor having a legitimate case. This would restore common sense to medicine by allowing doctors the ability to treat their patients accordingly and not run up all kinds of costs by covering CYA medicine and prescribing all kinds of extraneous tests that some ambulance chaser like John Edwards would use as a reason to sue them for malpractice. Not to mention bring down the malpractice insurance premiums.

    5. Award people tax credits that they can use to put in an HSA and then invest in low risk, high quality investments and use to pay for their insurance premiums and other out of pocket health care costs. This would be done in lieu of Medicaid and Medicare. We already spend the money on those things, lets put some control back into the hands of the consumers.

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  10. First of all, Scott I wish you well on the test. I have no doubt that you will do well and pass (I don't know about first time because I don't the usual test retest norms on it - i.e. most people needs two times to pass their CPA)

    The point of my posts is that the health care systems of European nations are subject to out-and-out lies. You again make the same mistake with your 70 year old woman with breast cancer example. That is simply not true. I really wish you would stop spreading lies about it. Just because Rush said it, doesn't make it true.

    Again, I have no problem with your proposals. I have posted the HSA with a $2,500 per American voucher/tax credit already.

    Whether or not the reform puts health care into the hands of the consumer (the HSA with credits) or the impartial hands of a non-profit organization like the government (will not be as bad Conservatives like to scare people into believing with the outright lies regarding Europe), I see positives in both.

    HOWEVER, it seems as if the compromise being reached by the Republicans and Democrats will address none of these concerns. The health insurance cooperatives being touted by both sides now is just a slight change from the status quo. This is something we both agree is not acceptable.

    I urge people, whether on my side of this debate or Scott L's, do not accept the status quo compromise being offered in DC. Call your Representatives in the House and the Senate and demand that whatever is passed in real reform and not the status quo under another name.

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  11. 1) A majority of Americans are happy with current insurance coverage (although we don't have an insurance, nor a free market, system).

    2) Regarding life expectancy variances - once you get infant mortality and basic hygiene under control, the life expectancy hits ~70 years - regardless of the medical system or the average costs per individual.

    http://geography.about.com/library/weekly/aa042000b.htm

    Sure, the Canucks hit 79 on average and the Brits nudge us out by 6 months. But, I would submit that this has more to do with lifestyle, genes, etc. than whether the money used to pay for health care comes directly out of an individual's pocket or whether it takes a circuitous route through D.C. before being distributed to the providers.

    3) While the right may point to anecdotal evidence that nationalized systems like the NHS can have terrible consequences (years waiting for surgery, the 10 month waiting list for a high risk pregnancy, etc), surely you're not suggesting that this is a phenomenon only employed on the right? We always hear horror stories (some factually untrue) about the current US system.

    When it comes down to it, we're not talking about health care - we're talking about the freedom to choose.

    I'm for the freedom to choose.

    There are a number of things that are wrong with our current system, but very few of those will be addressed by any bill drafted in D.C. Most of the things they are trying to "fix" are actually unintended consequences from Depression-era policies.

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  12. Oh, and one final question....

    By what Constitutional authority will Health Care insurance be passed?

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  13. "I'm for the freedom to choose."

    You are not this way on abortion, right? That is a choice, right? The use of cocaine, heroine, etc is a choice, right? Driving while drink is a choice, right?

    Be careful with this line of argument. We tend to be in favor of choices we agree with and oppose choices we disagree with.



    "By what Constitutional authority will Health Care insurance be passed?"

    By the same authority that created the FDA, EPA, FAA, FDIC, NEC, etc. All of these Congressionally approved and Presidential signed (on both sides of the political spectrum) and found Constitutional by a number of different Supreme Courts dominated by both sides of the political spectrum.

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  14. more details RE Life Expectancy & Health care system:

    http://www.nytimes.com/2009/09/22/science/22tier.html

    WRT to the other "choice" issues you raise - There are both moral and practical implications involved in each of those. They also have little bearing on the current discussion.

    On Abortion, you leave out the possible choice of the infant in the womb. The obvious question here is whether life has begun and whether the choice of that life should be respected. That's another topic in itself.

    How about assisted suicide? I am for the freedom to choose that - as long as it truly is the choice of the individual and not some decision by a bureaucrat (insurance or government) denying care, some doctor nudging them along, etc.

    I would note that drugs probably should be legalized, although there is understandably a public safety concerns and practical implications.

    Legalizing drunk driving is a ridiculous suggestion and has little bearing on a discussion on.

    My original point is this:

    When it comes down to our current health care system, many of its problems stem from unintended consequences of laws passed 60 years ago.

    If people truly purchased insurance - and not health care cost insulation policies determined & subsidized by their employers - we would have a better system.



    From the Census, 45 million uninsured consist of:

    25 Million live in households making $50k or more per year; 9 Million of these are in households that make more than $75k/year.

    15 Million could get coverage through Medicare/Medicaid (but either choose not to or are unaware that they are eligible)

    5 Million are foreign nationals (here illegally or legally)

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  15. "WRT to the other "choice" issues you raise - There are both moral and practical implications involved in each of those. "


    You raise good points. However, I do see this question as a moral one and not an economic one. How the wealthiest people on the planet could have the highest child mortality and lowest life expectancy rates to me is a judgment on the morality of the people.

    In your "REAL" numbers of people without health insurance, how many are included that have health insurance but a policy that is too expensive and covers too little? Yeah, I'm sure Republicans ideas of mandating coverage will fix that one.

    Funny your opinions concerning the post-WWII decisions are very ironic.

    After WWII, the United States faced a decision about health insurance. Democrat Harry Truman proposed a universal health care system with a government agency running it. It was opposed by the Republicans who favored the right of small businesses to choose insurance for its employees.

    Huh...Seems like our broken system was brought to use courtesy of the Republican Party.

    Seems to me that they've lost the moral authority to bring us a new broken system.

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  16. By the way, what does 'WRT' mean? I am not very good with text speak :-)

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  17. WRT = "With regard to".

    "However, I do see this question as a moral one and not an economic one. How the wealthiest people on the planet could have the highest child mortality and lowest life expectancy rates to me is a judgment on the morality of the people."

    Why do you keep insisting on using these blunt statistics that don't correlate with the quality of healthcare? And we don't have the highest infant mortality, its just a bit higher than some of the other countries that do have national systems, but again, I've pointed out the flaws with that as well.

    As I've said before and continue to maintain, you do not have a right to my stuff. Simple as that, really. Plus, the constitutionality of a Single Payer system is easy to see...its not in the constitution. If anything at all, it is left up to the states by the 10th amendment.

    BTW the "crappy" system that we currently have, which 80% of Americans are happy with, has been hindered over many years by well-meaning government intrusion and is not even remotely a free market system. We have not tried a real free market system for healthcare because the government has junked it up so much over time. So I contend that we ought to try the free market for real before signing away the last vestiges of freedom we have to a government that has nationalized the car industry, most of banking, all of student and home loans, and seeks to take over energy, financial markets, and anything else it can sink its talons into.

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