# Obama and EMS - the roll-on effect of universal health care



## Melbourne MICA (Nov 1, 2008)

I was wondering what the impact of trully universal health care will have in the US should Obama become president and and go on to introduce such a scheme.

In Australia we have had universal health care since the early 1970's. The "Medicare" system here is free to every Australian. It is funded by a small annual levy charged to all taxpayers.

This means all "public" hospital system based care is free irrespective of the procedure or time spent in hospital. You can have a heart transplant for free.

The system has been complicated by the idelological desire of conservative federal governments here to push people to "user pays" private health insurance models. This is fine for those able to afford it. But the fall back position, even with all its failings, is that you can still get free care in the public system for just about anything even dental care.

Unless I am mistaken this is where your system differs from ours.

What do you guys think will be the impact on EMS/ALS/BLS provision/funding/dispersion by the changes mooted by Obama to your private health insurance system and its level of coverage?

MM

PS (The latest polls in Australia have about 70% in favour of Obama).


----------



## Ridryder911 (Nov 1, 2008)

First thing one finds out in life is nothing is for free. One of the reason your health care is free and can be managed by a small levy is due to the population, the type and restrictions placed upon the citizens as well as the public perception of health care. It is much different and truthfully much better than those in the U.S.  I also ask what is the waiting time for those that are in need for a CABG or transplants. When comparing the number performed daily and those that are in need to that of those in the U.S. 

As well, majority of the pharmaceuticals and medical research is performed here in the U.S. Want to see a decrease in advances in new medications and procedures? Just place socialized medicine in place. Again, someone has to pay for it. I do believe you would see a crumbling effect upon the countries with socialized medicine. U.S. no longer or able to willing to perform, pay for research and implementation of medicine to other countries. Hey, maybe it would not be a bad idea after all? 

Truthfully, I realize Obama is lying. How do I know? His lips are moving. Alike McCain and any other politician that has ever ran for political office they will promise anything for a vote. The Clinton's (President Hillary and VP Bill) attempted and almost changed the medical payment structures in the U.S. Thankfully, AMA and other PAC's was able to shut them down before doing so. The demise of what would had occurred would had set medicine back decades in the U.S. 

There is NO easy answer. Someone will have to pay for it. Who that will be is the problem. Taxing the fat cat will never solve it. They will only raise the prices to off set their loss,and taxing the middle income..is  joke. The reason we are in a recession is because middle income is now in debt up to their ears. So we only have the rich and the poor left.. 

Yes, we need better way of doing things. Is socialized medicine the answer? Probably not. Preventative medicine and requiring one to be more responsible for their health and families health will have to be enforced.


----------



## ffemt8978 (Nov 1, 2008)

Ridryder911 said:


> First thing one finds out in life is nothing is for free. One of the reason your health care is free and can be managed by a small levy is due to the population, the type and restrictions placed upon the citizens as well as the public perception of health care. It is much different and truthfully much better than those in the U.S.  I also ask what is the waiting time for those that are in need for a CABG or transplants. When comparing the number performed daily and those that are in need to that of those in the U.S.
> 
> As well, majority of the pharmaceuticals and medical research is performed here in the U.S. Want to see a decrease in advances in new medications and procedures? Just place socialized medicine in place. Again, someone has to pay for it. I do believe you would see a crumbling effect upon the countries with socialized medicine. U.S. no longer or able to willing to perform, pay for research and implementation of medicine to other countries. Hey, maybe it would not be a bad idea after all?
> 
> ...



This post has my nomination for the post of the year.

Well said, Rid.  Truthfully, it would be great if we could provide healthcare to everyone.  Realistically, it will never happen because of these reasons.

To all of those that think socialized/universal healthcare is great, and point out those countries that have it I issue you a challange.  Please name ONE important advancement in either drugs or treatment procedures that has come from those countries in the past 30 years.  Pretty much every significant advancement in medicine has come from countries that don't have this type of health care.

In addition, there are large numbers of people that come to the US just to have a medical procedure done.  Why is that, if they have free health care at home?


----------



## EMTinNEPA (Nov 1, 2008)

ffemt8978 said:


> In addition, there are large numbers of people that come to the US just to have a medical procedure done.  Why is that, if they have free health care at home?



Ooh, ooh, I know, I know!!! Pick me!!

Because universal healthcare causes extensive waiting lines for every procedure known to man because every hypochondriac and mommy or daddy afflicted with NPS will sign up for every test in the book so you wind up waiting six months to have your appendix removed.


----------



## Melbourne MICA (Nov 1, 2008)

ffemt8978 said:


> Please name ONE important advancement in either drugs or treatment procedures that has come from those countries in the past 30 years.  Pretty much every significant advancement in medicine has come from countries that don't have this type of health care.



Australia had a conservative government ideologically opposed to universal health care for 12years but which was unable (or unwilling) to find a way to provide care to the many who can't afford to pay. We have "medicare" -  a "socilaized" system of universal health care if you like, and a also a taxpayer subsidised pharmaceutical benefits scheme as well. 

The conservatives almost gave it away at the behest of US pharaceutical companies in our free trade agreement with the US. (Sorry for that little dig)

They are now out of power and a Labor government is in.

Cohlear implants, heart and neuro surgical devleopments, breast cancer, diabetes, genetics advances and breakthroughs - We seem to manage research and development and have socialist health care at the same time.

Abuse of systems is a common theme for all of us. If its greedy Doctors or citizens taking shortcuts at others expense the result is the same.

MM


----------



## ffemt8978 (Nov 1, 2008)

Melbourne MICA said:


> Cohlear implants, heart and neuro surgical devleopments, breast cancer, diabetes, genetics advances and breakthroughs - We seem to manage research and development and have socialist health care at the same time.
> 
> MM



While your system may benefit from those procedures you listed, where were they developed?  I'm willing to bet that they weren't developed in a country with socialized medicine.


----------



## Hastings (Nov 1, 2008)

More money for EMS companies. Higher wages for EMTs. No more stress for companies in regards to collecting money.


----------



## Melbourne MICA (Nov 1, 2008)

*Home grown*



ffemt8978 said:


> While your system may benefit from those procedures you listed, where were they developed?  I'm willing to bet that they weren't developed in a country with socialized medicine.




I would beg to differ. Both  the UK and less so Australia have a "socialised" ( do you mean socialist?) that is, nationalised health system and each country has produced many outstanding developments in science even when under "socialist" or politically left leaning governments such as the Labor Party.

The examples I gave came from Australia not overseas. Here's one.

Dr Graham Clarke of Melbourne University developed probably the worlds most effective multi channel cochlear implant. (It wasn't the first I realise).

http://en.wikipedia.org/wiki/Cochlear_implants

Thats an aussie bloke working in a partly "socialist" type health system in the 1970's (when a Labor Government is in power). Our "medicare" system, by the way, has been retained by our conservative governments as well and has operated since 1973. 

The University of Melbourne by the way, receives a sizeable percentage of its research funding from the taxpayer and some from private investment. There is also a substantive governments grants scheme in Australia for research and development and a specialist govenment organisation, the CSIRO. There is also much private sector involvment as well often from overseas companies.

MM


----------



## John E (Nov 1, 2008)

*Does anyone really believe...*

that medical research will simply stop if and when the U.S. starts doing what every other civilised nation in the world does and provide health care to it's citizens?

Really? 

Are we to believe that all medical research has been profit driven?

Really?

I think with a minimum of research one might find that a great number of actual medical research breakthroughs were discovered by scientists and doctors that are NOT employed by pharmaceutical companies and the like. Unless one counts Viagra and Cialis as ground breaking medical research. And of course there's that drug that claims to cure "restless leg syndrome", a created cure for an imaginary disorder but I digress.

I suppose some of you folks think that Exxon/Mobil are leading the way in research for alternative energy too...

By the way, if in fact all this amazing medical research that is apparently only being done here in the U.S. by for-profit companies, doesn't it speak rather poorly of a society that life saving research is only done with a profit motive? Is that really something to be proud of?

John E.


----------



## Ridryder911 (Nov 1, 2008)

Actually, I believe if you research you will find the majority of new medications (including erectile dysfunction* and antibiotics, cardiac medications, oncologic as well) are developed, researched and then copyrighted by U.S. based companies. Even if the company makes the product out of country, it may still be owned and funded by a U.S. firm.

The top twenty pharmaceutical companies : 

Revenue Rank 2006   Company  

1 Johnson and Johnson U.S.  
2 Pfizer U.S.  
3 Bayer Germany  
4 GlaxoSmithKline United Kingdom  
5 Novartis Switzerland  
6 Sanofi-Aventis France 
7 Hoffmann–La Roche Switzerland  
8 AstraZeneca UK/Sweden 
9. Merck & Co. U.S.  
10 Abbott Laboratories U.S.  
11 Wyeth U.S.  
12 Bristol-Myers Squibb U.S.  
13 Eli Lilly and Co. U.S.  
14 Amgen U.S. 
15 Boehringer Ingelheim Germany  
16 Schering-Plough U.S.  
17 Baxter International U.S.  
18 Takeda Pharmaceutical Co. Japan  
19 Genentech U.S.  
20 Procter & Gamble U.S. 


If you don't believe there is some hand shaking and deals for the development of drugs, products, and exclusive rights .. then I have some land to sell you. 


* erectile dysfunction med.'s are actually vascular medications
R/r 911


----------



## bonedog (Nov 1, 2008)

ffemt8978 said:


> To all of those that think socialized/universal healthcare is great, and point out those countries that have it I issue you a challange.  Please name ONE important advancement in either drugs or treatment procedures that has come from those countries in the past 30 years.  Pretty much every significant advancement in medicine has come from countries that don't have this type of health care.
> 
> Why is that, if they have free health care at home?



Insulin-Banting/Best...CANADA

Glad we have FREE TRADE with you guys and can access your excellent-world leading medical proceedures, while our government pays for it. THANKS cousins, sure glad we don't have them HMO's here, I like my house.

Tommy Douglas was voted our GREATEST CANADIAN also the man responsible for Universal Health Care here.


----------



## karaya (Nov 2, 2008)

The United States has lead the world in medical innovations for nearly three decades. In a 2001 poll, of the six most important medical innovations (MRI, CT scan, ACE inhibitors, balloon angioplasty, mammography, and bypass grafts) four were developed in the United States and others were improved in the United States to the point of making them "workable commercial technologies." No other country in the world spends as much their gross domestic product on medical care as the United States.

In the last 10 years up to 2006, fifteen Nobel Prizes in medicine were awarded to American scientists working in the United States and three of those to foreign scientists also working in the United States. Only 7 awards went outside the United States.

These medical innovations have benefited other countries worldwide (including Canada and Australia) in improving their health care and life expectancy at the expense of American research and development. _The expensive American health care system, complete with its flaws, has been the driving economic engine to support world wide life saving research._

The funding for the bulk of this research comes from the private sector. Biomedical research in the United States ( in 2003) was estimated at nearly $94 billion dollars with more than half of that coming from the private sector. While all European Union governments combined spent only $3.7 billion. This may in part explain why 400,000 European researchers are living in the United States. (Source: Tyler Cowen, New York Times, Economic Science)

Yes, we do have problems in our health care system. But to suggest that a socialized program here in the United States is the answer would be disastrous to the advancement of medical research worldwide. Canada and Australia can afford such a programs in their countries because in part they have benefited from our medical developments and advancements.

The costs for socialized care is prohibitive here in the United States and not just in the monetary sense. Money used and generated by the private sector for research would be dramatically reduced and therefore advancements in health care would decline. There is just too much at risk with such a proposal and it is a risk that would impact the world as a whole.


----------



## MMiz (Nov 2, 2008)

Who is suggesting socialized health care?  As far as I can tell neither candidate supports socialized health care.


----------



## Hastings (Nov 2, 2008)

MMiz said:


> Who is suggesting socialized health care?  As far as I can tell neither candidate supports socialized health care.



Or economic communism, but enough people still believe Obama does.


----------



## karaya (Nov 2, 2008)

MMiz said:


> Who is suggesting socialized health care? As far as I can tell neither candidate supports socialized health care.


 
It can be debated as one's interpretation of socialism or even Obama's intent to develop a single-payer health system; something Obama has gone on record in the past as supporting.

For instance, under Obama's proposal, employers would be forced to offer and contribute a "meaningful" contribution toward health coverage or pay a tax. His plan would also require insurance companies to cover pre-existing conditions so all Americans regardless of their health condition can get health care insurance. 

Now some will argue that these two provisions alone teeter on socialism. But, I feel the intent of Obama is to _eventually_ get to a single-payer health system via his proposed health care plan should it get implemented. 

The Obama plan to force insurers to approve all applicants will in effect lead to a reduction of healthy people from obtaining health insurance. People will save on premiums by waiting until they need the coverage should they become ill then obtaining coverage at that time. In the past, some states had mandated a "guaranteed coverage" law which saw the same results as described above and therfore forced the insurers to withdraw from providing coverage in that particular state.

The Obama plan could have the same effect, but will result in the collapse of the private health care system. Guess where this will then force everyone to get health insurance? Yup, the government universal plan that will then become a single-payer program and can be dutifully labeled socialized health care!


----------



## enjoynz (Nov 2, 2008)

ffemt8978 said:


> This post has my nomination for the post of the year.
> 
> 
> 
> To all of those that think socialized/universal healthcare is great, and point out those countries that have it I issue you a challange.  Please name ONE important advancement in either drugs or treatment procedures that has come from those countries in the past 30 years.  Pretty much every significant advancement in medicine has come from countries that don't have this type of health care.



OK here is an article of a few from New Zealand!
http://www.natlib.govt.nz/collections/online-exhibitions/contemporary-scientists/medicine

Cheers Enjoynz


----------



## MMiz (Nov 2, 2008)

Though I respect many of the people in this thread, what you're saying makes very little sense.  No presidential candidate in the past two decades has delivered on any sort of or form of socialized medicine, and with good reason.  I see that both candidates in this election want to provide easier and cheaper access to health care, but go about it differently.  I would imagine that no matter who wins the election, their campaign platform will evolve during their presidency, just like every other candidate in U.S. history.

You can put on your tinfoil hats and hide election day, but I don't see either candidate's health care goals as revolutionary or worrisome.


----------



## BossyCow (Nov 3, 2008)

MMiz said:


> Though I respect many of the people in this thread, what you're saying makes very little sense.  No presidential candidate in the past two decades has delivered on any sort of or form of socialized medicine, and with good reason.  I see that both candidates in this election want to provide easier and cheaper access to health care, but go about it differently.  I would imagine that no matter who wins the election, their campaign platform will evolve during their presidency, just like every other candidate in U.S. history.
> 
> You can put on your tinfoil hats and hide election day, but I don't see either candidate's health care goals as revolutionary or worrisome.



Now wait a minute.. we have to draw the line at bringing common sense into a political discussion... Admin???? Are you watching????


----------



## ffemt8978 (Nov 3, 2008)

BossyCow said:


> Now wait a minute.. we have to draw the line at bringing common sense into a political discussion... Admin???? Are you watching????



Ummm...it was THE ADMIN that did that.  h34r:


----------



## wxduff (Nov 5, 2008)

Just a counter argument, I'm sure we can make up for the loss of research funding by funding research as a nation.

When John Doe pays for their HMO you realize that 31% of what they pay is pure profits, after all costs like workers salaries, paperwork, and costs of procedures and other health care?

And a Universal Healthcare system could eliminate up to 350 billion dollars in paper?

Between the two of those I think it's safe to assume the following:
1. Everyone can get good, solid, affordable coverage.
2. An increase in the demand for medical services would allow for job creation in the medical field, including EMS.
3. We could still afford to fund research.
4. No-one would have to be in fear of being dropped by their provider when they get really sick. No fine print, you're covered.

I'm sorry but some things don't work when run for profit. The world health organization ranked America 37th in the world as a health care system, right below COSTA RICA and DOMINICA. I mean seriously... The worlds economic super power, yet #37 in health care?

And you're list is nice Rid, but every other country on that list has a better healthcare system then us, and I'd rather have theirs.

Healthcare research is not going to disappear if we get Universal Healthcare, instead its going to be run by people doing it because they care, instead of profit. And seriously, WHAT GOOD IS ALL THIS MEDICAL RESEARCH IN THE U.S IF SO FEW AMERICAN'S CAN EVEN AFFORD IT.


----------



## bonedog (Nov 5, 2008)

Excellent counter wxduff, you get it.

I understand 10X the research funds for breast cancer is spent on male pattern baldness, another thing that might change if alturistic individual's were in charge of where the research dollars go.

Oh yeah and congrat's on the new president elect, he seems much more intelligent than his predecessor.


----------



## Ridryder911 (Nov 5, 2008)

Either afford healthcare or the inability to pay taxes to fund it. 

R/r 911


----------



## Sasha (Nov 5, 2008)

wxduff said:


> And seriously, WHAT GOOD IS ALL THIS MEDICAL RESEARCH IN THE U.S IF SO FEW AMERICAN'S CAN EVEN AFFORD IT.



Amen, brother! <3


----------



## EMERG2011 (Nov 5, 2008)

Speaking as someone who has worked both in EMS as well as on both the Clinton and Obama campaigns - the type of national healthcare system being proposed (and soon implemented) by the Obama administration isn't a single payer healthcare system a.la Canada or Scandanavia, but rather a universal system of health insurance. Its projected that by providing the 47 million American citizens with comprehensive health insurance overall health costs will go down, hospital overcrowding will decrease, and the incidence of preventable disease will decrese. Furthermore, because more people will have access to healthcare, WE wont have to pick them up and take them to the hospital because they had (insert disease/malady here) for the past week/month/year and cant go see a PCP because of a lack of insurance. 

Essentially - in the end, we all win.


----------



## firecoins (Nov 5, 2008)

EMERG2011 said:


> Speaking as someone who has worked both in EMS as well as on both the Clinton and Obama campaigns
> Essentially - in the end, we all win. Essentially - in the end, we all win.


That sounds nice.  The promises made by politicians of previous social programs were usually much greater than the actual results. We will get stuck with something that falls way short of the promises plus the higher taxes to pay for it. The politicans will refuse to fix the program or cut it. We get stuck with whatever problems it creates without the promised benefits.


----------



## EMERG2011 (Nov 5, 2008)

One more thing - 

Most major medical breakthroughs have been dependent on money from the Federal government (think: pcn, MRI, CT, AZT). While private pharma does play a major role in drug/treatment protocol development, federal funding is the cornerstone of modern research.

PS - The Obama plan doesnt take any money away from the Pharma companies, all it does is ensure that individual consumers have full access to the drugs. If anything, Pharma would see a RISE in profits because of this plan.


----------



## Ridryder911 (Nov 5, 2008)

EMERG2011 said:


> Speaking as someone who has worked both in EMS as well as on both the Clinton and Obama campaigns - the type of national healthcare system being proposed (and soon implemented) by the Obama administration isn't a single payer healthcare system a.la Canada or Scandanavia, but rather a universal system of health insurance. Its projected that by providing the 47 million American citizens with comprehensive health insurance overall health costs will go down, hospital overcrowding will decrease, and the incidence of preventable disease will decrese. Furthermore, because more people will have access to healthcare, WE wont have to pick them up and take them to the hospital because they had (insert disease/malady here) for the past week/month/year and cant go see a PCP because of a lack of insurance.
> 
> Essentially - in the end, we all win.



If you believe that crap, I have some lovely land I will sell you and a 88 Ford only drove by my Grandma on Sundays. 

I too was active during President Hillary and her V.P. Bill. Thank - GOD that it never went through. One of the only few times I donated to a PAC and supported AMA. 

Investigate the B.S. on what and how reimbursements are made As well, tell me the last time you actually saw someone denied health care? Sorry, I see a lot  of freeby healthcare and NO it does not encourage them for preventative care and NO it has not yet reduced EMS responses. Really, everyone with a health card and no one will be able to know if they are covered or not... yeah, I see physicians jumping on board that. 

What it can and will reduce is reimbursement rates for all health care (i.e EMS) as well as reduction in reimbursements to speciality (i.e. neurology, etc) areas and then we will see those specialties only accept private or insurance covered patients. Don't think so? Look at how many are already abandoning Medicare and Medicaid. As well, read AMA and the AOA statements. Do you think a physician will accept the nominal payment of government captivated rates? Dream on...  

Again, there is NO easy answer and again someone will have to pay for it one way or another. Unfortunately, many assume the government is the answer.


----------



## rhan101277 (Nov 5, 2008)

Whatever can get EMS more money to get better equipment and training for more life saving interventions is good for me.  Is it a far stretch for paramedics to be able to do chest tubes?  I know they can do the little needles but it really doesn't let out much blood.

But free healthcare for everyone sounds good, but I bet it comes at a cost of higher taxes.  I like Obama's social security package, I think he was going to eliminate lower/middle class giving into it and upper class paying more.  I think he defined upper class as 250K plus.


----------



## wxduff (Nov 5, 2008)

Ridryder911 said:


> If you believe that crap, I have some lovely land I will sell you and a 88 Ford only drove by my Grandma on Sundays.
> 
> I too was active during President Hillary and her V.P. Bill. Thank - GOD that it never went through. One of the only few times I donated to a PAC and supported AMA.
> 
> ...



So if were under a national health care plan, doctors will start only taking privately insured patients? That sir is complete bull. They would make more money from people now going to the doctor instead.

I don't understand your logic, but it's broken, and the obvious doesn't seem to sink in .

Insurance for all will raise patient numbers for doctors and other medical fields. They will still get competitive pay due to increased demand. That's a no brain-er. Some of these organizations are against universal health care because they are funded by *HMOs*. Obviously HMOs are against universal healthcare, because they can't *RAPE* anyone anymore. THEY are the ones that will pay, and they deserve it after they have raped private consumers and small business for years. Universal Healthcare will be cheaper than an equal plan through an HMO any day. Universal Healthcare eliminates the 31% of healthcare spending to profit, the 350 billion dollars in paperwork, administrative costs, and elevates the level of care for everyone. 

Everyone wins, and that's not a fantasy, it's reality, and its already been proved in other parts of the world.

If Obama goes through with a universal healthcare system, the people of this country as well as this country's medical industry will see a rise in efficiency, affordability, and fairness.


----------



## JPINFV (Nov 5, 2008)

wxduff said:


> If Obama goes through with a universal healthcare system, the people of this country as well as this country's medical industry will see a rise in efficiency, affordability, and fairness.



Just like all the other countries? So tell me, then, in the magical socialized health care world, why is it that England is finding it hard to find dentists willing to treat patients after the dentist has met their patient quota? Why are the lines for surgeries so long in Canada that there are Canadians willing to private pay to come to the US for their surgery?

Personally, if it came down to getting an "elective" quality of life surgery (like hip replacement) quickly (as in not waiting several years) or having my life expectancy increase by 2 years (which would move the US from 30th in life expectancy to 11th in life expectancy and place the US within a year life expectancy of 3rd place to show how tight the field is at this level), I'd rather live a shorter, fuller life than a longer, lower quality life.


----------



## Ridryder911 (Nov 5, 2008)

Many speciality physicians have went to private pay and insurance only. Evaluate the number of neurosurgeons that nowno longer work in trauma centers or in fact take non-insured trauma patients. Don't believe me look at trauma center rotations and diverts.

In my state nearly all the neuros banded together and formed their own hospital and NO they do NOT nor will they participate in trauma care.. Why? Poor reimbursement rates. 

I am not in favor of HMO's nor PPO's but I am realist. I DO know how things are reimbursed and not. I DO know that any reimbursement rate will not fulfill the pay structure for speciality physicians and YES they will quit seeing patients that are government insured. Just alike many obstetrics has as well. 

Don't know what how it is in your part but even ACoS even discussed the dilemma of trauma care and possibility outcome. Now, I have seen speciality hospitals in cardiac care do the same.. no private insurance, no admittance. 

Like I said, I have seen this before nothing new and alike I said those that income are based upon high reimbursement rates have the highest lobbyist groups. Nor matter or whom is in office, it won't change. 

R/r 911


----------



## EMERG2011 (Nov 5, 2008)

Ridryder911 said:


> If you believe that crap, I have some lovely land I will sell you and a 88 Ford only drove by my Grandma on Sundays.



While I am always glad to be on the recieving end of a verbal bear baiting, I do have to point out that the Obama plan is HARDLY HillaryCare. HillaryCare 1.0 would have been a true national one-payer system of federal health insurance. This plan is a multi-payer system, wherein the American people will be given access to health insurance plans that are already in existance, and proven to be both effective for the patients and care providers across the board. 

Example: Say you're a 50 YOM with pre-existing cardiac disease, and a strong family history of Alzheimers. In the current system, few if any health insurance companies would take you on, because the actuarial tables would say that you were too great a risk. Under this plan, if you are able to pay your premiums and copays, the insurance company would have to take you on. Furthermore, if you cant find a plan to your liking, you would be able to buy into the Federal Employee Health Benefits Plan (FEHB). The FEHB itself is not a singular plan, but rather an organization of government sub-contractors (i.e. Blue Cross/Blue Shield), which provide full coverage at discounted rates. The FEHB is available in all 50 states, as well as overseas. Under the FEHB, the 50YOM would pay an average of $300 a month to cover dental, drugs, doctor visits, hospital visits, surgeries, etc.  Such a plan under another provider could be in excess of $1000 a month.


----------



## GeekMedic (Nov 5, 2008)

*Isn't the goal equal access?*

Neither the US system or the Canadian system are perfect, up here we have crazy wait times to see a specialist or have a procedure done. (faster if your life depends on it), Down there it appears to me people are avoiding going the their GP for a minor ailment due to the perceived or real cost, and waiting until they get worse, resulting in a trip to the ED and a significantly larger bill.

FYI in Canada we do have to pay out of pocket for for meds, optometrists, dentists, and 'non medically necessary procedures'  non of wich come cheap despite the cap that the gov't has on prescription meds.


----------



## wxduff (Nov 5, 2008)

Ridryder911 said:


> Many speciality physicians have went to private pay and insurance only. Evaluate the number of neurosurgeons that nowno longer work in trauma centers or in fact take non-insured trauma patients. Don't believe me look at trauma center rotations and diverts.
> 
> In my state nearly all the neuros banded together and formed their own hospital and NO they do NOT nor will they participate in trauma care.. Why? Poor reimbursement rates.
> 
> ...



Rid, my simple point is, if America goes to a Universal Healthcare system, they wont deny universal healthcare patients, because we will ALL be universal healthcare patients, except for the very wealthy and the stubborn. Not accepting these patients is like putting a gun to your career's head.

So you can stop pushing the point, it's bad logic, again...


----------



## Melbourne MICA (Nov 5, 2008)

wxduff said:


> Just a counter argument, I'm sure we can make up for the loss of research funding by funding research as a nation.
> 
> When John Doe pays for their HMO you realize that 31% of what they pay is pure profits, after all costs like workers salaries, paperwork, and costs of procedures and other health care?
> 
> ...




Well put WXDUFF

The same arguments about private sector markets being self regulatory led to the current financial debacle, and the same private system at work unrestrained has America No 37 and 47 million of its own citizens left in the lurch.

A balance of private capital and investment plus a public competitor in the market place with a regulatory system that makes all the players accountable to the same common goal - real health care for everyone - is the way to go in my book. 

Private sector self regulation and "market forces" - that intangible non-corporeal entity beholden to no-one but the concept of a bottom line - read shareholder greed factor - is a beast with no reigns keeping it in check. 

"Temptation", that lovely old biblical term is what drives the mindset  of the private players. They can't help it. It's in human nature. When the private sector is faced with providing service or taking the money and running when someone smells big dollars do we honestly think they will "do the right thing" and take a smaller share of the profits for the sake of their role as "good corporate citizens"?

Not on your life. And history has proved this time and again, most recently of course with the current financial melt down.

When the private sector bemoans the involvement of the government in their market it's usually because they will have to play fair. Like the utilities and energy sectors (remember the fraud and market manipulation that occurred in the Californian energy sector and the huge power outages that resulted?) - the standard mantra is that the public system can't run these things efficiently, service will suffer and costs blow out.

This is a whole lot of guff. But that's a debate for another kind of forum.

If "socialization" of health care as others have put it means the system is run more in line with the perceptions of the public about what they should rightfully expect from society and tax dollar outlays  then I'm all for it.

The reliable old workhorse of the public sector plus the thoroughbred of private industry with rider attached holding the reigns.

MM

PS Obama's extraordinary victory is a milestone in the American body politic.
The rest of the world seems to think it is a damn mighty fine thing. I hope it works out that way for you guys in the US. Best of luck.


----------



## ffemt8978 (Nov 5, 2008)

Melbourne MICA said:


> If "socialization" of health care as others have put it means the system is run more in line with the perceptions of the public about what they should rightfully expect from society and tax dollar outlays then I'm all for it.



I'm curious where this belief that society or the government owes anyone healthcare.  Last time I checked, healthcare is not one of the things listed in the Constitution.


----------



## Melbourne MICA (Nov 6, 2008)

ffemt8978 said:


> I'm curious where this belief that society or the government owes anyone healthcare.  Last time I checked, healthcare is not one of the things listed in the Constitution.




I don't know - Perhaps it should be.

Given the US constitution was written in Philadelphia in 1787 it is hardly surprising that there was no ideological premise underlying the provision of health care for all citizens written into it. Its omission may well have reflected the views of Jefferson etal but I don't believe so. Nonetheless the conceptual basis for a health care "system" IE an organised and widespread delivery model still arose out of the public domain.

Prior to this those with nominal incomes or the poor and destitute relied heavily on the altruism of the medical professions of the day. Even then you could guarantee there were no poor people with their own "physician" and access to advanced medical procedures was all but non-existent.

Indeed the poor and powerless of the underclasses were often the guinea pigs of medical research. Further they were often blamed for the rise of epidemics. 

Their squalid living conditions. lack of sanitation and hygiene, poor education and access to basic health care provision helped to cement their place on the lower rungs of society.

Given the lessons learned at the time of the value of widespread health care both in human and economic costs it remains surprising that the concept didn't gain traction across all ideological spectrum's. Given the largely agrarian and trade goods economies of the day, the pandemics of the 15th through 18th centuries decimated the very workers relied upon by the merchant and upper classes to maintain their businesses and incomes. The flow on effect for nations was often economic catastrophe.

Even today we have medical catastrophes with enormous economic consequences. Flu pandemics, even widespread outbreaks of seemingly trivial medical problems like gastro can shut down businesses and produce millions of lost man hours at workplaces. The dollar cost can be felt at local, regional or even national levels.

I would think that lifting the bottom line of health care both in terms of scope and in the level of dissemination does more than just make a poor person feel more a like a rich one because they can get a heart transplant too.

The flow on effects are to both the economy and the social fabric of the population.

It's a trite argument, typically shovelled out by the political right, that the idea of "universal health care" is some evil contrivance of the "socialists" (read communists - I wish people would just  apply the tag that they really mean but don't actually understand) with the next step being chanting political mantras each day and seeing all of us wearing olive drab overshirts whilst plowing the fields singing dogmatic anthems.

It isn't. It makes sense in every respect. Plenty of countries have tried it irrespective of the incumbent governments ideological position (though more common to the left of centre of course). Some have met with mixed results others with great success.

The problems typically lie with efficient implementation but this belies the veracity of the concept. But they also lie in the corporate mindset. To my way of thinking, the evidence doesn't seem to reflect much in the way of "social responsibility" being demonstrated by corporate anybody (not just corporate America by the way). Look what the big pharmaceuticals tried to do to stop generic aids meds in Asia and Africa.

Individual effort, entrepreneurialism, reaching for the stars - all good stuff. But resistance from the private sector ( because they feel threatened - or more correctly they don't want their profits "shared around") has ridden on the back of American ideals like those mentioned for too long.

I don't know that that's what your forefathers exactly had in mind when they wrote the constitution whether they included a section on "universal" health care as a right or not. Maybe the "Life" part of ..."life liberty and the pursuit of happiness" was a broader and more complex metaphor than we realise.

Anything "collective" or universal" doesn't have to be a threat to the foundation principles of the American heart and mind.

All societies evolve. Perhaps with Obama you will see the beginning of a new paradigm in the way americans feel and think about many things including health care. Perhaps in a few years many an American family will breathe a sigh of relief and find comfort in knowing that their fellow Americans (through the government) are not only watching their backs (security) but watching their health as well.

Time will tell I guess.   Here hoping.

MM


----------



## ffemt8978 (Nov 6, 2008)

To paraphrase President Ronald Reagan, "The scariest words in the English language are, 'I'm from the government and I'm here to help you.'"

It's long past time we stop looking to the government to take care of us and instead take responsibility for our own selves.  After all, all men are created equal does not mean that all men will end up as equals.  Life is what you make of it.


----------



## EMERG2011 (Nov 6, 2008)

ffemt8978 said:


> To paraphrase President Ronald Reagan, "The scariest words in the English language are, 'I'm from the government and I'm here to help you.'"
> 
> It's long past time we stop looking to the government to take care of us and instead take responsibility for our own selves.  After all, all men are created equal does not mean that all men will end up as equals.  Life is what you make of it.



While in basic prinicpal I agree with you, I have to point out that your assertion, and the assertion made by the late President Reagan is based on the assumption that everyone is given an equal shot at birth. While it is an unfortunate reality, a baby girl born in Appalachia does not have the same opportunities as a baby girl born in suburban Maryland. The role of government in this situation is to raise up the downtrodden so that there is a truly level playing field. Its one thing for us to be talking about government intervention with homes to keep us warm at night, and internet to keep us connected to the world; and its another thing entirely when a sick woman in Southeast Washington DC who cant afford to heat her crumbling home talks about paying either her medical bills or her electricity bill. While you personally may not agree with the new system, sometimes government DOES have to step in, and ensure not just the survival, but the blessings of freedom and living in the nation with the best, most advanced healthcare systems in history are endowed upon everyone.


----------



## Ridryder911 (Nov 6, 2008)

Why is it my fault you do not have the money or work for an employer that does not provide health care insurance? Why should I have to work an additional job and make sacrifices? 

I do realize there is the needy and those that need a hand up and NOT a hand out. Unfortunately, giving people what they need has never nor ever worked. The " Great Society" is the worse thing that ever occurred. We have made people dependent upon others to "provide" for them. 

There is programs that will provide preventative medicine, but unfortunately this is NOT what the society wants. They much rather go to a ED to be treated because why? It's faster and there is no payment required!

 I have worked IHS hospitals where there is free preventive and even free medicine and care and majority was non-compliant. Free health care, free medicine, even a paid van or ambulance to transport and still will bombard the ED. 

I have triaged patients to the clinic because their condition was not warranted as "life threatening" yet, they refused to go because: 1) They would have wait to be seen by the PCP (even though they had an appointment for that day) 2) The PCP can actually charge (nominal) fee. 

I will be all for governmental free health care as soon as : 

They have to ensure no bad habits or deterrents such as smoking, alcohol or substance abuse is causing or affecting the outcome of the disease process. 

They are placed on a limited time schedule. Unless a catastrophic illness then one should only be allowed so much. 

I am sure the ideas are well intention but realistic it is not. Remember, where Obama was an attorney for.. Revco. 

R/r 911


----------



## Melbourne MICA (Nov 6, 2008)

EMERG2011 said:


> While in basic prinicpal I agree with you, I have to point out that your assertion, and the assertion made by the late President Reagan is based on the assumption that everyone is given an equal shot at birth. While it is an unfortunate reality, a baby girl born in Appalachia does not have the same opportunities as a baby girl born in suburban Maryland. The role of government in this situation is to raise up the downtrodden so that there is a truly level playing field. Its one thing for us to be talking about government intervention with homes to keep us warm at night, and internet to keep us connected to the world; and its another thing entirely when a sick woman in Southeast Washington DC who cant afford to heat her crumbling home talks about paying either her medical bills or her electricity bill. While you personally may not agree with the new system, sometimes government DOES have to step in, and ensure not just the survival, but the blessings of freedom and living in the nation with the best, most advanced healthcare systems in history are endowed upon everyone.




As they say here in the Australian Parliament when they agree passionately with the speaker - "here here".

It's about *making* governments care not expecting them to simply because they are the government. Because they are not the government  - you are - ".....Of the people, by the people, for the people".

The government is the arm of public will that sets ideas into motion. At least it should be.

If the public thinks the government doesn't care it's because the public don't. Agitate for change the way Obama did. He got it - you can too.

Nick (MM)


----------



## fortsmithman (Nov 6, 2008)

Now it's my country Canada that has a right wing government.


----------



## Melbourne MICA (Nov 6, 2008)

Ridryder911 said:


> Why is it my fault you do not have the money or work for an employer that does not provide health care insurance? Why should I have to work an additional job and make sacrifices?
> 
> I do realize there is the needy and those that need a hand up and NOT a hand out. Unfortunately, giving people what they need has never nor ever worked. The " Great Society" is the worse thing that ever occurred. We have made people dependent upon others to "provide" for them.
> 
> ...




I hear where you are coming from Ryds and I've been there too. The world is full of bludgers, spongers and opportunists. If we are to have free anythings there must be filters in place to weed out these kinds of individuals but not to disadvantage the genuine.

What you are expressing is frustration - the same feeling any EMT with a taste of a few years in the job has felt many times. And government systems are open for abuse that is clear - always have been.

But for every occasion where I have seen some knuckle head get a free ride out of the system I have seen decent hard working people get value for money out of "free" public services. (And don't kid yourself that they are truly free - they never are). 

Some are old, some young, some very deserving others who could have found a better alternative. 

I have even seen the very rich benefit, deservedly, from free health care particularly in emergencies and have nothing but praise for every component of the system, often surprised by how effective it was.

From the ambos who met them at the door, to the equipment and training we possess, to the nurses, doctors and facilities at their disposal for themselves or their loved one in crisis - and this time no-one said - "do you have private insurance" or "you have to sign this payment schedule before we can provide treatment".

There are filters against abuse and perhaps this is where the system is often let down as the respective ideological positions argue over who is deserving, where you should discriminate and above all how we judge who gets the freebies.

And you're right about dependency. But this is not a failing of the system itself but of society as a whole. Press a button, make a call, fill in the form and the pizza will be delivered to your door courtesy of the taxpayer.

Getting some sort of health service is often no different that setting up a mobile phone account. 

What happened to self reliance and common sense? Perhaps we've had it too easy for too long but tell that to the have nots.

It's too easy to judge all by the actions of the few. The majority of calls for EMS are genuine even if sometimes misplaced. Education is key and those few EMS services who have taken the plunge and dared to tell the public how to use the system wisely will reap the rewards in reduced demand. But of course it doesn't end there. 

There has to be a mindset among the population (this is where doing the right thing comes in) that it is "un-american" to abuse the "system". This can start with the kids telling mom that they were shown at school that EMS is very busy and only for emergencies not sore throats right through to if necessary billing, penalty and other more punitive measures.

As for smokers, drinkers and drug takers - I wonder if we start being selective about who pays what relative to "poor lifestyle" decisions we might at the same time bill the companies that have marketed, pandered, indoctrinated, lied, conned, abused, denied responsibility but in the end still made billions out of those idiots (like me) who got sucked into the dependent substance maelstrom?

You talked about why should you have to pay for others? Were they too dumb, poorly educated, cheapscapes, mistaken, overanxious, not aware of alternatives - it's hard to know which at times. But this is our perspective not theirs at the time crises happens or the point where they call upon a service.

You might be on a decent wage with no major debts, a reasonable and comfortable lifestyle but when your kid gets that rash that you're not sure about what will you do? If he falls over, bangs his head seems OK but you read about the insidious progression of extra dural haemorrhage what will you do?

You may well shell out the bucks happily for the care. Others can't. Others can but will endure some level of sacrifice anywhere from missing out on the six pack this week to mortgaging the family home so the child makes it through the night.

Many taxpayers are irritated by the idea of paying for others and often justifiably so. But it's all a matter of context and situation. 

We all make sacrifices under public systems. You may well be surprised how big some of the sacrifices are for the users on the other end of the line.

MM


----------



## Melbourne MICA (Nov 6, 2008)

fortsmithman said:


> Now it's my country Canada that has a right wing government.



Go Stephen Harper  - (but he can thank that good old lefty Tommy Douglas for universal health care in Canada).

MM

PS found this interesting piece whilst trawling for info

http://circ.ahajournals.org/cgi/content/full/109/12/1460

PSS I'm pleased to say my remarks citing the US constitution and health care were written here before I found this article. No plaigarisim here.


----------



## JPINFV (Nov 6, 2008)

Melbourne MICA said:


> I don't know - Perhaps it should be.
> 
> Given the US constitution was written in Philadelphia in 1787 it is hardly surprising that there was no ideological premise underlying the provision of health care for all citizens written into it. Its omission may well have reflected the views of Jefferson etal but I don't believe so. Nonetheless the conceptual basis for a health care "system" IE an organised and widespread delivery model still arose out of the public domain.




Alternatively, the founders realized that you can't grant someone a right at the expense of someone else. In fact, most of the "rights" guaranteed by the constitution isn't so much a right as much as it's a limitation on the government. This is an important distinction. For example, there *is* a difference between "Congress shall make no law respecting... abridging the freedom of speech, or of the press;" and "Citizens have a right to freedom of speech." One is a limitation on the government, the other is an affirmation. As a strict interpretation of the second one, shouting over someone could be considered a civil rights violation. Following a strict reading of the second phrasing, moderation on a message board would violate a person's civil rights. 

In fact, in the US Bill of Rights, there's only one clause that requires the work of a citizen to meet the civil rights of another. After all, everyone loves jury duty. 

Now, how does this go towards the discussion of if health care is a right or not. Simple, health care is based on the service provided by an individual. If health care is a right, would a physician who refuses to treat a patient in a non-emergent situation be violating that patient's right to health care? What if that patient can't pay, should the tax payers fit the bill or should the provider work for free? After all, it costs the citizens nothing to meet the rights set forth in the constitution outside of the right to a trial by jury. Furthermore, now that the tax payers are fitting the bill for health care, shouldn't the tax payers have a say in a person's health decisions? Should tax payers be required to fit the bill for cancer treatments for a patient that smokes? Alternatively, should society just ban smoking, alcohol, fast food, etc? Just because health care becomes a right (hey, I'm still looking for that "right to privacy" clause in the constitution that the supreme court found when ruling on Roe v Wade) doesn't mean that the problems of implementation have all of a sudden been solved.


----------



## Melbourne MICA (Nov 6, 2008)

JPINFV said:


> Alternatively, the founders realized that you can't grant someone a right at the expense of someone else. In fact, most of the "rights" guaranteed by the constitution isn't so much a right as much as it's a limitation on the government. This is an important distinction. For example, there *is* a difference between "Congress shall make no law respecting... abridging the freedom of speech, or of the press;" and "Citizens have a right to freedom of speech." One is a limitation on the government, the other is an affirmation. As a strict interpretation of the second one, shouting over someone could be considered a civil rights violation. Following a strict reading of the second phrasing, moderation on a message board would violate a person's civil rights.
> 
> In fact, in the US Bill of Rights, there's only one clause that requires the work of a citizen to meet the civil rights of another. After all, everyone loves jury duty.
> 
> Now, how does this go towards the discussion of if health care is a right or not. Simple, health care is based on the service provided by an individual. If health care is a right, would a physician who refuses to treat a patient in a non-emergent situation be violating that patient's right to health care? What if that patient can't pay, should the tax payers fit the bill or should the provider work for free? After all, it costs the citizens nothing to meet the rights set forth in the constitution outside of the right to a trial by jury. Furthermore, now that the tax payers are fitting the bill for health care, shouldn't the tax payers have a say in a person's health decisions? Should tax payers be required to fit the bill for cancer treatments for a patient that smokes? Alternatively, should society just ban smoking, alcohol, fast food, etc? Just because health care becomes a right (hey, I'm still looking for that "right to privacy" clause in the constitution that the supreme court found when ruling on Roe v Wade) doesn't mean that the problems of implementation have all of a sudden been solved.




These are all thorny questions for which I don't have answers.

I'd have to be honest and say I'm opening up a can of worms for myself by pretending to have any great insights into the US constitution or bill of rights.

Suffice it to say you could take an ideological position and venture interpretive arguments about what your forefathers meant or implied by the philosophical premises of the constitution. Perhaps you can infer nothing without making grandiose but unsubstantiated hypotheses about "rights".

But you can also take a pragmatic position and say; Look at the state of play currently. Is this situation acceptable? Without a doubt the current US health care system is off the mark by a fair margin.  Is it "right" to see so many of your citizens in this position? 

So, what are the alternatives?

Unfortunately one of the answers, universal health care, always gets tarred with a political brush by its opponents and has done so for decades. The concept of "Rights", who has control of the revenue streams of health care and the role of that big ogre, government are common themes. 

I found this article from 1971 as an example of that point.

http://www.aapsonline.org/brochures/sademcr.htm

Contrast the cerebral and I think supercilious attitude of this author with this article from the American Heart Association .

http://circ.ahajournals.org/cgi/content/full/109/12/1460

What I think we see from this is an evolution of thought and philosophy.

It always urks me to hear vested interest groups whose sole intent is to protect their own turf and flow of money espouse self righteous attitudes about rights and morals and how the constitution is being undermined, its all about free choice. Its a service that one purchases so user pays is the best way to protect rights etc.

Their real argument in the end is about where the money goes and who gets it. But how many of those bellicose stakeholders will you get who readily admit this is their only interest?

There are plenty of parties with a stake in the process. This includes Doctors, hospitals and especially the insurance industry.

If we are to learn anything from your Presidential election it's this: people have gut instincts and a genuine sense of community when you cut to the chase - revealed most apparently when all the facades are stripped away as a result of crises.

In the end all the talk about rights and choice will be seen for what it is. A distraction from the truth.

A revolution in thought is what drives change and it will do the same with your health care system. And the US public will demand it because THEY think it it is right.

No; making health care a "right" for all citizens doesn't solve the implementation problems. But why is it so wrong to try?

After all you already have some universal health care systems in the US like  the Veterans and Military Health care programmes.  

Rights and choice are not necessarily opposing forces or immutable chemistry's.

People have a funny habit of being adaptable and supportive of change. They also have their own mind and a sense of both common purpose and what is "right" for the individual and society as a whole.

Obamas election proved this and demonstrated many things; remarkable, positive, exemplary, inspiring things about the US. One of those is who really controls the government - you do. The conscience of America was given a fair old shaking and your citizens rallied. Common sense can prevail, the greedy and self interested can be put in their place. 

However difficult, complex and costly implementing and managing a large public health system will be, I'm sure the US will figure it out. You have the brains, the money and the flexibility built into your nation to do it.

But you have to believe it to make it happen.

I think you already do - you just haven't realised it yet.

MM


----------



## John E (Nov 6, 2008)

*Clap, clap, clap...*

One of, if not the best post I've ever read on any web forum ever.

The preamble to the U.S. constitution says it plainly;

"We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America."

Promote the general welfare and secure the blessings of liberty, it doesn't take a constitutional scholar to know what that means. We can argue all day about the amendments and the rights granted vs rights restricted, the premise of the document is clear. The rest of it is simply the hows and the wherefores.

Ensuring that people have access to medical care regardless of their financial status is simply the right thing to do in a civilised world.

If there's a best of EMT Life collection, I nominate Melbourne Mica's contributions to this thread for inclusion.

John E.


----------



## JPINFV (Nov 6, 2008)

Too bad the preamble is a window dressing, or else how would you explain court decisions like US v Lopez? I'm pretty sure that keeping guns out of school is a good way to promote the "general welfare" by keeping schools safe.


----------



## ffemt8978 (Nov 6, 2008)

John E said:


> Promote the general welfare and secure the blessings of liberty, it doesn't take a constitutional scholar to know what that means. We can argue all day about the amendments and the rights granted vs rights restricted, the premise of the document is clear. The rest of it is simply the hows and the wherefores.
> 
> Ensuring that people have access to medical care regardless of their financial status is simply the right thing to do in a civilised world.



But those are the most important parts.  The Constitution was written at a time, and with the aim, of severely limiting and restricting what a government could do to it's citizens.

Since you brought it up, how does securing the blessings of liberty in any way pertain to health care?  I can see the argument for the general welfare part, but I just don't see how liberty equates to health care.

As to your last statement, we've done a lot of things in this country simply because they are the "right thing to do in a civilized world" only to learn later that they have serious and unintended consequences.  Personally, I don't think it's the right thing to do without violating other premises and intents of the Constitution.  Our government should only be as large as needed to perform it's duties, not as large as it can be to take care of us.


----------



## Melbourne MICA (Nov 6, 2008)

John E said:


> Ensuring that people have access to medical care regardless of their financial status is simply the right thing to do in a civilised world.John E.



If I may humbly submit - I think you just summed up all my hot air in one sentence.

Democracy hurts don't it? But how bloody good is it too live in one!!!:blush:

Nick


----------



## JPINFV (Nov 6, 2008)

Melbourne MICA said:


> If I may humbly submit - I think you just summed up all my hot air in one sentence.
> 
> Democracy hurts don't it? But how bloody good is it too live in one!!!:blush:
> 
> Nick




Even democracy still has to be in line with the frame that the government was constructed with. Democracy is not the same as consenting to mob rule.


----------



## Melbourne MICA (Nov 7, 2008)

JPINFV said:


> Even democracy still has to be in line with the frame that the government was constructed with. Democracy is not the same as consenting to mob rule.



I'm not quite sure what you're getting at JP. Could you elaborate?

MM


----------



## EMERG2011 (Nov 7, 2008)

JPINFV said:


> Even democracy still has to be in line with the frame that the government was constructed with. Democracy is not the same as consenting to mob rule.



To quote Senator Barbara Boxer  - 

"Elections have consequences"


----------



## JPINFV (Nov 7, 2008)

Melbourne MICA said:


> I'm not quite sure what you're getting at JP. Could you elaborate?
> 
> MM



Citizens can not demand something from their government that the government is not empowered to provide by the constitution. It doesn't matter what the people demand if that demand is not constitutional. Now, yes, it is possible to adjust the constitution, but it is not easy and we've learned the hard way through prohibition that legislating via constitutional amendment is something that we shouldn't rush into.


----------



## Melbourne MICA (Nov 7, 2008)

JPINFV said:


> Citizens can not demand something from their government that the government is not empowered to provide by the constitution. It doesn't matter what the people demand if that demand is not constitutional. Now, yes, it is possible to adjust the constitution, but it is not easy and we've learned the hard way through prohibition that legislating via constitutional amendment is something that we shouldn't rush into.



So are you saying that the introduction of a universal type health care scheme would require a constitutional amendment?

You've had 26 amedments to the constitution over the years have you not?

Maybe the legislators should think big for a change instead of tinkering at the edges? 

And maybe now is the time with the impetus and goodwill created by Obamas' win. The republicans will be begging for their voters to come back and the democrats nervous about keeping control of both houses when the mid term elections next come around.

All these pollies need is a none too subtle nudge in the right direction from the public and as many knowledgeable advocates as can be mustered. 

The realities of the mess are hard to ignore and with the patriotic fervour you all must be feeling right now it would be downright embarassing to face the next four years with the US still ranked at number 27 in the world for health care with some of the highest prices as well. (According to an article in Wiki from an analysis done in 2003 the US spends an average of $620/month on health care for each and every citizen).

Worth a try?

MM


----------



## ffemt8978 (Nov 7, 2008)

Melbourne MICA said:


> So are you saying that the introduction of a universal type health care scheme would require a constitutional amendment?
> 
> You've had 26 amedments to the constitution over the years have you not?
> 
> ...



What is being said is that if our government is to get involved in something that is beyond it's powers as defined in the Constitution, it would require a Constitutional Amendment.  Just because every one is all touchy feely with "the impetus and goodwill created by Obamas' win" doesn't mean that the Constitution can be ignored.

No one has come up with the answer to how to fund universal healthcare in this country without a major increase in taxes.  I've got a suggestion...we'll stop spending billions of dollars every year on foreign aide to countries, regardless of what they need it for.  That alone would pay for it and then some.  The $34,360,000,000 (as of 2005 per this source) would then have to come from those countries that currently have socialized/universal healthcare.  I wonder how effective their systems would be if they had to fork over this much money to other countries.


----------



## Melbourne MICA (Nov 7, 2008)

ffemt8978 said:


> What is being said is that if our government is to get involved in something that is beyond it's powers as defined in the Constitution, it would require a Constitutional Amendment.  Just because every one is all touchy feely with "the impetus and goodwill created by Obamas' win" doesn't mean that the Constitution can be ignored.
> 
> No one has come up with the answer to how to fund universal healthcare in this country without a major increase in taxes.  I've got a suggestion...we'll stop spending billions of dollars every year on foreign aide to countries, regardless of what they need it for.  That alone would pay for it and then some.  The $34,360,000,000 (as of 2005 per this source) would then have to come from those countries that currently have socialized/universal healthcare.  I wonder how effective their systems would be if they had to fork over this much money to other countries.



FF I'm still not sure whether you're saying it would definately require a change in your constitution to implement a universal health care scheme.

If it does why the hell not? What could be more important? 

Given the amount of money our countries spend on weapons, gambling, meaningless throw away consumer goods, government waste, tax cuts for the rich, corporate greed, pollution etc where is the logic to not making access to health care for all an absolute priority?

As for how you pay for it - like the constitution I can claim no great knowledge. But from what I understand if tax was taken out of pay packets it would replace the insurance premiums you currently have deducted as one example.

In Australia we have a small levy ,1.5%, that is deducted when you fill out your tax return each year. You make a million dollars a year and you pay 1.5%of that towards the medicare levy.

At the other end, if you make a pittance you don't pay if below the level of taxable income. As for scrutiny - someone always asks why you haven't filled out a tax return. At the other end, those on welfare or receiving government support are on the books. All government benefits are means tested.

This system has been in operation continuously since 1973 without too many hickups. If you want the extras you pay for private health insurance packages that provide benefits to suit your needs. Most middle and upper class individuals have some level of cover to pay the dentists bills for the kids etc. The system isn't adhoc - its very specific. If you can pay something you pay one way or the other. It depends on your immediate (or longer term)needs (like people with disabled kids that get sick all the time) and the acuity of the situation.

How much do you fork out in each pay packet for insurance cover? If you had to pay a percentage levy each year (not each pay) and balanced to what you actually earned with the option to keep private cover based on your particular needs and income would you be better off?

And if you were an auto worker say and made redundant what happens to your private cover then? Here (and elsewhere) you can still get health care. It might not be Rolls Royce level but its there for everyone - always.

Alternately a 1% cut in your defense budget would yield what dividend that could be put towards health care subsidy?

Maybe being free of the last incumbents foreign policies will also yield fruit in goodwill from countries and regions where cooperation has been a vexatious issue adding exorbitant costs to your foreign affairs (and defense) budgets that could be better spent elsewhere.

Perhaps there is more to be gained in opportunities born of goodwill that will return dollars to US citizens where they should be than many realise. 349 college votes to 163 is valuable human capital that the US can now invest overseas to benefit those at home.

And if you need to change the constitution to do it is it an effort worth making? The last time it was changed back in 1992 (27th amendment) was to limit congressional pay rises. 

MM


----------



## Ridryder911 (Nov 7, 2008)

Again, I ask .. "Why I am responsible for your health care?" Why should I be responsible or even be asked to be taxed more? 

Seriously, should I be responsible as well for you to be able to purchase a vehicle, purchase a home, obtain an education? 

This is where the waters get muddied. Many ask why should it be even placed into a government role? Again, the difference is many in the U.S. want less government involvement not more! It should be a government of the people, by the people; not always a government to give to the people on just some services that only some need. Again, a hand up NOT a hand out, and again careful screening for those that truly need it not just one believes they deserve it because they simply exist in life. 

Again, what many outside the U.S. do not understand in our differences in conservatism and liberalism. Less involvement and dependence from the government versus service from the government.  

Are we going to require that to be covered that the government mandate yearly physical examinations and eat a healthy diet, exercise, and compliance to medications? If not, should they not be required to meet such obligations? Would we want the government to be so involved and again should it not have some obligations attached to it? Should it be a free reign for all? Should those that can afford private health care be able to receive that CABG and neurosurgeons in a timely manner versus those that cannot be places in line? Where is the fairness and the best medical care there... and still everyone will be paying for it. Would it be fair to say if you want excellent care, you must pay twice? The government then an additional private insurance. 

I am truly playing devils advocate. I do understand the needs for those that cannot afford healthcare. Yet, to be able to defend and to be able to justify; one has to be able to answer such questions. 

R/r 911


----------



## Melbourne MICA (Nov 7, 2008)

Ridryder911 said:


> Again, I ask .. "Why I am responsible for your health care?" Why should I be responsible or even be asked to be taxed more?
> 
> Seriously, should I be responsible as well for you to be able to purchase a vehicle, purchase a home, obtain an education?
> 
> ...



The question is always asked about the perceived incumberence of "paying for someone else". I don't think anyone here could answer those questions about the whys and hows.

The idea of reciprocity is common to all societies even one steeped in the  rights and position of the "individual' like the US. Often the reciprocity, that is, everyone giving as well as taking from the common wealth, seems unbalanced or unfair. Sometimes even outrageous. 

How your taxpayer dollars are used to fund the military and then employed for less than legitimate, even immoral purposes not in keeping with the belief systems of your kin is perhaps the most glaring example of this.

For all the "inalienable rights" we might think we have there are issues that require we forego some individual liberties or assets for the common good and as a measure and expression of our values. And there are times when the need becomes paramount.

Another way to look at how your money is spent on others is to say, well if I must I would rather have it spent on the most important things. Your political parties, like ours, have been arguing these issues for decades.

The left and right of politics, liberals and conservatives, are, however, little different no matter which western democracy you live in.  And there are all shades of red and blue within those parties.So I don't know that what you say is necessarily correct about the US being so different.

But as for the role or size of government - you can't really have a small government delivering large amounts of services and little regulation. Services require a bureaucracy. Lots of services, lots of public servants.
Ours is about 4.5/1000 head of population. 

Why do we have them and what do we expect of them? How much do or should our governments reflect the ideals upon which our particular brand of society is based? And which ideals are the most important. Or are they simply there to be administrators and accountants.

Well for me the most important measure of society is the level of its compassion. If you want to go out of the political and into the religious, compassion is also a fundamental tenet of the christian faith and clearly one implied and expressed in the constitution and bill of rights.

Lets not forget that all it takes is an unfortunate turn of events (or perhaps a huge financial crisis) to turn the tables on your life. Economists say that the average wage earner is but 4 or 5 pay cheques away from the poor house. 

So if you want to know why you should or would contribute to the well being of someone else your reasoning should be because America is a compassionate society and one day you may need someone elses compassion even if it comes in the form of a taxpayer funded service. 

As for the how, there is no point us attempting to figure out economic problems because I for one don't know all that much about economics.

There is every conceivable type of expertise within government (and from the private sector) to achieve these ends - and the funding as well. We don't need to fret about how - thats what we pay for and expect them to do with our taxes. And do it well they must.

With the state the US is in at the moment there is going to be greater need for compassion than ever before and your country will change for the better because of it. This is natural. And the US has to evolve.

The fact that universal care is even being talked about is I think an expression of a dawning evolution in America. The obsession with money often expressed through the notion of individulaism has come badly unstuck and your'e all suffering for it.

Things have to change - In health care and elsewhere. There's 47million of your countrymen who are really hoping it will I'm sure.

MM


----------



## JPINFV (Nov 7, 2008)

Melbourne MICA said:


> So are you saying that the introduction of a universal type health care scheme would require a constitutional amendment?
> 
> You've had 26 amendments to the constitution over the years have you not?
> 
> Maybe the legislators should think big for a change instead of tinkering at the edges?


I can almost guarantee that there would not be a constitutional amendment any time soon regarding health care. For a constitutional amendment to succeed, it would need approval to be proposed by either 2/3rds of both houses of the federal legislature or 2/3rds of the individual state legislatures and then passed by 3/4s of the states either through the legislature or through state convention. It's not designed to be an easy process to undertake. If anything, it's much more likely that any sort of health care plan would simply not be taken up by the supreme court. 




> And maybe now is the time with the impetus and goodwill created by Obamas' win. The republicans will be begging for their voters to come back and the democrats nervous about keeping control of both houses when the mid term elections next come around.


The republicans are not going to win votes by going against the limited government banner that they claim to hold. 


> The realities of the mess are hard to ignore and with the patriotic fervour you all must be feeling right now it would be downright embarassing to face the next four years with the US still ranked at number 27 in the world for health care with some of the highest prices as well. (According to an article in Wiki from an analysis done in 2003 the US spends an average of $620/month on health care for each and every citizen).
> 
> Worth a try?
> 
> MM



As I stated earlier, I find it funny when people throw out rankings in life expectancy since the field is so packed? What level would be good, then? The United States is ranked 30 in the Wiki article (going by member UN nations and not by countries plus territories) with eight countries being within a year and 20 within 2 years. Furthermore, you have to look at the size of the country. Ironically, actually, the closest country in population size to the US is Japan, the number one country by life expectancy. The US has a little over twice the population as Japan. 

Now here's the kicker, we have 30 times the land area as Japan. If health care is a right, shouldn't people in the less populated areas have the same access to health care as people in the cities? Well, you can't just go around plopping tertiary health care centers in the middle of no where to insure a town of 5000 has equal access to health care.


----------



## bonedog (Nov 7, 2008)

It seems people are fearful of government involvement in healthcare and the money they will have to put out.

I guess this fear isn't realized in the bail out of the insurance/banking failures, which would be a large shot in the arm towards a universal system.

Rationing healthcare related to lifestyle choices is a slippery slope. We all see the results of these choices, however, where and who could draw these lines?

Obesity is rampant, maybe there should be legislation targeting the corporate food giants who add glucose/fructose. 

What about females who choose not to procreate until after 30, should they not be covered for breast cancer?

I guess the whole universal health care discussion is a mute point now as you have overwhelming voted for Obama.... as MM would say " Good on ya mate"


----------



## JPINFV (Nov 7, 2008)

bonedog said:


> What about females who choose not to procreate until after 30, should they not be covered for breast cancer?


How about mothers over the age of 40 who give birth to a child with Downs syndrome? 


> I guess the whole universal health care discussion is a mute point now as you have overwhelming voted for Obama.... as MM would say " Good on ya mate"


Since when was 52% of the popular vote an "overwhelming" majority? Besides, there's always the filibuster.


----------



## karaya (Nov 7, 2008)

bonedog said:


> It seems people are fearful of government involvement in healthcare and the money they will have to put out.
> 
> I guess this fear isn't realized in the bail out of the insurance/banking failures, which would be a large shot in the arm towards a universal system.
> 
> ...


 
I tend to get a chuckle when people from other countries try to weigh in on American issues they know little about.

The bailout is a huge fear in terms of the amount of money it will cost taxpayers which so far is in the trillion dollar region and is expected to rise. When the bail out passed a few weeks ago that dealt the death blow to universal health care for some time. The money is just simply not there. To suggest that the bail out is a shot in the arm for universal health care is economically absurd.

Exit polls showed that Obama was elected as a result of economic concerns in our country and not his universal health care proposal. As a matter of fact, when the banking collapse began to rear its ugly head a few weeks ago the political issues shifted toward the economy and hardly anything was mentioned about universal health care since.

Obama's own acceptance speech even suggested that this will be a long hard road and that his goals may not even be achieved in the first year or during his first term. His programs will require major tax increases in order to fund his trillion dollar plus entitlements and economically speaking, this is something Americans are not in a position to stomach.

Obama is faced with some enormous challenges. How can he keep his campaign promises and do it without dipping into American wallets during this economic crises?

This county is sharply divided. JPINFV is right in his fact that 52% of the vote is hardly "overwhelming". With the state of the economy and the mounting U.S. debt, universal health care fell off the radar screen weeks ago and it will be a long time before it reappears.


----------



## wxduff (Nov 7, 2008)

Can we do some math people?

Lets say that the current cost of an HMO is 100%. And let's remember as I said before that because HMO's run on profit, 31% of you're insurance costs go to towards profit.

Alright, now lets take 100% and subtract 31%

What does that equal? 69%. This is the MAX cost to you of universal healthcare in comparison to your HMO. The real number would probably lower in the paperwork and administrative savings alone.

So take you're income. Subtract your HMO cost, and add 69% of that.

So compare you're income under an HMO, and then compare it to Universal Healthcare.

Low and behold, you have MORE money, as well as the satisfaction of knowing you're helping others.

Win-Win? Yes?

I thought so.

So enough of this bs that you're going to pay more if there's universal healthcare. Ok?


----------



## JPINFV (Nov 7, 2008)

Would you please provide the source that shows that 31% of HMO revenue is profit?


----------



## wxduff (Nov 7, 2008)

Sure.

http://www.pnhp.org/single_payer_re...te_consumes_31_percent_of_health_spending.php


----------



## karaya (Nov 7, 2008)

wxduff said:


> Can we do some math people?
> 
> Lets say that the current cost of an HMO is 100%. And let's remember as I said before that because HMO's run on profit, 31% of you're insurance costs go to towards profit.
> 
> ...


 
The cost's we are referring to are the tax subsidization that will be necessary to maintain such a program. What little premiums that are paid in will be no where near enough to sustain such a program.

Obama's plan is to reduce the uninsured by 26 million or so by 2010. The federal tab to enact his program is estimated at a whooping 1.7 trillion dollars from 2010 to 2019! Guess where that will come from? And don't say people who make more than $250,000 per year. That proposed tax increase will only generate about 50 billion a year.

Here's the kicker to all of this... Obama still plans to increase foreign aid to fight global poverty by $845 billion dollars above what we are already spending over the next 13 years! No wonder he's been endorsed by so many countries! They get some of our taxes too!


----------



## Melbourne MICA (Nov 7, 2008)

> I can almost guarantee that there would not be a constitutional amendment any time soon regarding health care. For a constitutional amendment to succeed, it would need approval to be proposed by either 2/3rds of both houses of the federal legislature or 2/3rds of the individual state legislatures and then passed by 3/4s of the states either through the legislature or through state convention. It's not designed to be an easy process to undertake. If anything, it's much more likely that any sort of health care plan would simply not be taken up by the supreme court.



I guess that depends on how desperate for change in health care people really are, how much the political parties stand to gain and how effectively the case is then argued. 

I seems you don't need a constitutional amendment to implement a universal health care reform agenda.Minnesota has a universal health care programme. So it would appear it can be done state by state. 

"The Healthy Minnesota bill, SF1689/HF1856, makes a commitment for the state to achieve universal coverage by 2011" 

http://www.healthyminnesota.org/



> The republicans are not going to win votes by going against the limited government banner that they claim to hold.



That very much seems to depend on the circumstances and how well existing systems are functioning. It is also reflected in the perception of how many voted aparty stands to lose at election time by holding out against a wave of public disquiet and desire for reform.

Here's the way Bushs (partial) Nationalisation of your banking sector was reported in different place around the world. Just two years ago any self respecting republican would have probably smacked you in the mouth for suggesting such heresy from a republican official, especially the executive branch.  

http://www.newvision.co.ug/D/8/20/651884
http://www.independent.ie/national-news/financial-crisis/us-banks-partnationalised-1498992.html
http://www.guardian.co.uk/business/2008/oct/14/us-banks-bailout-bush/print
http://debtonation.org/2008/09/comrade-paulson-nationalised-banks-socialism-for-the-rich/

People change, parties change, circumstances change.



> As I stated earlier, I find it funny when people throw out rankings in life expectancy since the field is so packed? What level would be good, then? The United States is ranked 30 in the Wiki article (going by member UN nations and not by countries plus territories) with eight countries being within a year and 20 within 2 years. Furthermore, you have to look at the size of the country. Ironically, actually, the closest country in population size to the US is Japan, the number one country by life expectancy. The US has a little over twice the population as Japan.



I think thats cherry picking the facts, no offense intended. The truth is your own population (and politicians) thinks your health care system is a disaster not just because its inefficient (most health systems can make a claim for that title) but because it actually excludes a huge segment of the population from access. (47million). Various studies and analyses have been done over the years and we could choose to ignore them. 

The US is ranked 37 in the world for health care according to the WHO. 

http://www.who.int/whr/2008/en/index.html
http://www.photius.com/rankings/healthranks.html
http://www.reuters.com/article/latestCrisis/idUSN07651650
http://www.csmonitor.com/2004/0505/p02s01-uspo.html

Some argue against the methodology. If it's wrong then exactly where does the US system "rank"?

http://www.ilw.com/articles/2008,1106-peron.shtm

Some even think its a "socialist" or commie plot.

http://www.fee.org/pdf/the-freeman/1107Peron.pdf

But that 47million number just keeps coming back to bring us back to reality.



> Now here's the kicker, we have 30 times the land area as Japan. If health care is a right, shouldn't people in the less populated areas have the same access to health care as people in the cities? Well, you can't just go around plopping tertiary health care centers in the middle of no where to insure a town of 5000 has equal access to health care.



This is always going to be a problem - its a practical reality for sure. You don't need to necessarily have tertiary medical centres but there are always large central regional hospitals that cater for most things.Helicopter and fixed wing retrievals from rural and regional ares are common here as they are else where and move patients pretty effectively where tertiary care is required.

We can keep debating these points endlessly at we still arrive back at the same destination - where we started.

The US needs health care reform badly. There are an unacceptable number of your citizens being left out and neglected and this reflects poorly on your countries standing in the international community. Nobody's perfect of course but what is Americas excuse if these are harsh criticisms - the Richest, most technologically advanced nation on the planet.

Lots of countries like the idea of universal coverage for their populations. They like it in economic and practical, political terms and they like it philosophically - it seems like the right thing to do for people.

The US needs to get over the cold war mentality and simply embrace systems that are functional, effective and meet the needs of the population.
(This doesn't necessarily mean a universal system by the way).

The US will not metamorphosis into a new "commie" or "socialist" state because you adopt a universal scheme of health care.

But you have to try something at this point even if it seems a radical departure from you're philosophical or dogmatic position.

MM


----------



## karaya (Nov 7, 2008)

We have not completely neglected those 47 million as you suggest.

What's interesting in this thread is that there is no mention of our Medicaid program which is funded by both the State and Federal government and is designed for the needy, especially children. Uncle Sam foots about 60% with the states picking up the rest of the tab. As of 2005, nearly 50 million people were receiving their medical care from Medicaid at a cost to the government of nearly $300 billion dollars!

Your points (Melbourne MICA) as to our health care system, at least in the beginning of this thread were eloquent and somewhat thought provoking and showed some intelligence. However, your last post concluded with a simplistic analogy that you perceive Americans as some sort of commie fearing morons that just can't seem to comprehend what's in our best interest especially if it works for other countries such as Australia or Canada. 

Your country has absolutely nothing to gain if we do or do not adopt a Universal health program. What's it to you where we rank on the flawed WHO rankings? Yes, we may be 37th, but even with your Universal health care, Australia ranks 32nd. Not exactly a sweeping revelation in numbers is it? And we have nearly 16 times the population you have!

Yes, you are correct that our health care system suffers. Is Universal health the sweeping answer or even part of the answer? I doubt it giving the poor health habits we Americans have eaten, smoked and drank ourselves into and that includes the poor and rich alike.

Our economy is teetering on upheaval and everyone wants a bail out. Obama made his first press conference today with the entire subject on the economy. As I said in a earlier post, Universal health care is well off the radar for the foreseeable future. There just is no money in our coffers to pay for such a program.


----------



## ffemt8978 (Nov 7, 2008)

Doing it state by state is different than having the federal government do it.  States have different powers and responsibilities than the federal government.  But if each state does it individually, then it's not "universal" healthcare now is it?


----------



## karaya (Nov 7, 2008)

ffemt8978 said:


> Doing it state by state is different than having the federal government do it. States have different powers and responsibilities than the federal government. But if each state does it individually, then it's not "universal" healthcare now is it?


 
Pretty close. Massachusetts passed a law that went into effect last year that requires everyone to have health insurance or face a fine. The state also developed their own subsidized universal health plan that varies in premium depending on income. However, the state underestimated the number of uninsured residents and the budget for universal care has ballooned to more than twice as what was originally estimated.

In addition, the number of primary care providers in Massachusetts has not increased thus putting a burden on the health care system in which long waits for medical procedures (similar to Canada's problem) plague Massachusetts.

Massachusetts may be a good model to watch to see how they overcome their financial funding problems and overwhelmed primary care providers. The concept for the care seems sound in theory, but is clearly off to a rough start.


----------



## bonedog (Nov 8, 2008)

I would like to see how the states would rank if gunshot deaths weren't included.


----------



## Melbourne MICA (Nov 8, 2008)

karaya said:


> We have not completely neglected those 47 million as you suggest.
> 
> What's interesting in this thread is that there is no mention of our Medicaid program which is funded by both the State and Federal government and is designed for the needy, especially children. Uncle Sam foots about 60% with the states picking up the rest of the tab. As of 2005, nearly 50 million people were receiving their medical care from Medicaid at a cost to the government of nearly $300 billion dollars!
> 
> ...



I take your point and agree that my closing remarks were simplistic. It was not my intention to flag wave and in so doing rub peoples patriotic sensibilities the wrong way  - that's the last thing any of us need at this point in time. The truth be told health care is a massive problem everywhere including in my own country.

If I may defend at least a couple of my remarks however. 

When I referenced the WHO rankings I hyperlinked the Who site and a couple of others that mentioned the rankings, But I also referenced some web pages critical of the methodology used. One was even suggesting the ranking was a biased socialist leaning analysis done by the chairwoman of the committee doing the report. Thus I was trying to avoid a bias on my part.

Our WHO ranking leaves much to be desired without a doubt and is heavily influenced by the shameful health statistics associated with our indigenous population. Their current life expectancy is 17yrs less than the Australian average. It's our national disgrace and has been for decades. We're working on it but finding real solutions elusive.

I know for a fact that Americans are not "commy fearing morons". The US has produced masterly works of political analysis, some fearless critics of policy offered from both political camps and from individuals who spoke out (particularly during the hottest period of the Iraq war) against the tide of public mood and the kind of fear-mongering for which the Bush/Cheney administration has now passed into folklore. 

Krugman, Chomsky, Woodward, Friedman (Thomas and George) - some right wing some left just to name a few. (Krugman is a staunch supporter of free market economics for example).

There are many great voices of moderation within the political parties themselves and within main street America.

For any affront I caused by making injudicious remarks on this front I apologise. 

Yet there remains disquiet that the McCain camp felt there was mileage to be had from their perception that there remained an undercurrent of public sentiment about anything "socialist" by attaching this highly symbolic tag to Obamas policies especially when he was mooting the idea of universal health care. 

I am certain that the perceptions of the American people are far more sophisticated than the republicans understood and the result of the election seemed to express this.

There's no doubt Bush and co. drove political commentary and policy to the far right making it all the more incongruous and ironic that he ended his term of office "socializing" a fair sized chunk of the banking sector.



> Your country has absolutely nothing to gain if we do or do not adopt a Universal health program. What's it to you where we rank on the flawed WHO rankings? Yes, we may be 37th, but even with your Universal health care, Australia ranks 32nd. Not exactly a sweeping revelation in numbers is it? And we have nearly 16 times the population you have!



On this quote however I will beg to differ and not perhaps in the way you might be expecting.

The rest of the world has everything to gain by successful health care reform in the US. However insipid and corny this remark may sound, the US *IS* the beacon of the western democracies. None of us can afford to have your nation anything less than number one in pretty much everything - especially health care.

Your size, your wealth, your prodigious abundance of talent, your technological innovativeness, your innate ability to see past the obvious to lateral solutions for problems, the openness of your society, your extraordinary ability to embrace,to harbour and to coalesce both conservative ideology and liberal thought into the same breath,........and on and on. 

You could run out of ways to describe why we all look to you in the US to be a champion. When you fail, we do too.


Obama was perceptive enough to recognise that he was talking to all of us in Grant Park. I sat glued to the screen for five hours right from the first count.
I was terrified at the prospect of him losing as much as I admire John McCain personally.

When he strode onto the stage to a cacophony of human voices that would drown out a football crowd or the detonation of an atomic bomb all present knew we were witnessing a transcendent moment in world history as much because we needed it to be than because it was for him being there.

By the time he had finished his acceptance speech you could see a pot pouri of American society all smiling, all crying, all embracing each other like lifelong friends. 

It was a moment to savour for an eternity. 

America is about to embark on a new journey of self discovery as only you Americans can. You will embrace change, you will step past dogma, past partisanship and you will wake to a new era that we will all follow because you did it in the way that only America can.

When health care comes into focus as it must, probably in a couple of years, your players will right a new programme of health care innovation that will become the template for others to follow. I believe it will include some level of universal coverage but with a twist. The twist we in other countries who use such systems with only moderate success hadn't thought of yet.

And when you do, we will be watching, listening and definately paying attention. Under Obama, perhaps for the first time in long time you will also be listening to others as well. It will be new coalition -  a coalition of the ready, willing and able. Yes We Can.

"The reason I have seen farther than some is because I stood on the shoulders of giants".

MM


----------



## karaya (Nov 8, 2008)

Well I must say it is certainly refreshing to discuss political views with someone as yourself who has clearly some intelligence of the facts. I do respect your view points and they are certainly some points that I will store in my memory banks and see how they compare with the future of our next president.

Although I respectfully disagree with your outlook on Obama, I do realize that I may be wrong about my assertion of the man as well. The proof is in the pudding as the say and we'll see what is in store for us in the next four years.

I was not one of the millions who was mesmerized with Obama'a aura as you were. I found it disturbing that his campaign developed a "creepy cult like" following. School children singing songs about him, people chanting "change" and strong political portrait posters that were reminiscing of the ones in the eras of Lenin and Mussolini. Not to mention terrorist organizations openly endorsing his candidacy.

I just couldn't find it in myself to vote for a man who was a Senator for 140 some odd days before he decided to run for president. We just don't know anything about him; at least in the area of public office. 

But now Obama is my president and I will give him the respect as my president. The campaign is over and it is time to move on. I do look forward to see what develops in the next four years.

Again, Melbourne, I have enjoyed your thought provoking conversation. Some of my friends supported Obama, but could not discuss any facts with reasonable intelligence. They were completely driven by the idealogical media. You at least have taken the time to look at both ends and for that I doff my chapeau.

Thank you.


----------



## Greentag (Nov 8, 2008)

rhan101277 said:


> Whatever can get EMS more money to get better equipment and training for more life saving interventions is good for me.
> 
> Good statement; also economically benificient. Allow me to elaborate(note the root word "bore"). Je suis Canadian. Love beer, hockey, ...eh? The ambulance service in our Province(state) got taken over by a private company. The buget for our ambulance service previous to them was about 11 million. Afterwards about 80 million anualy. They got that amount of money because they proved that if you treat people sooner, with a highly educated prehospital service, the amount of money spent per patient at the hospital or rehab is significantly reduced. We/they are working on evidence based protocols and constantly involve us in different research to see if we can't teak patient care. The basic thought in our SOCIALIST health care service is to keep our patients healthy so they can pay taxes longer


----------



## karaya (Nov 8, 2008)

Greentag said:


> The basic thought in our SOCIALIST health care service is to keep our patients healthy so they can pay taxes longer


 
You can't be serious? Do you not procreate in your Providence to born future taxpayers?


----------



## Melbourne MICA (Nov 9, 2008)

karaya said:


> Well I must say it is certainly refreshing to discuss political views with someone as yourself who has clearly some intelligence of the facts. I do respect your view points and they are certainly some points that I will store in my memory banks and see how they compare with the future of our next president.
> 
> Although I respectfully disagree with your outlook on Obama, I do realize that I may be wrong about my assertion of the man as well. The proof is in the pudding as the say and we'll see what is in store for us in the next four years.
> 
> ...



Its been terrific participating. What goose said you should never talk about politics? What more important subject is there? Especially in these times?

I guess will all move on to more "interesting" ALS topics but if there remains a little life in this thread I'm happy and keen to continue to bring a southern hemisphere perspective.

I'm thinking I might have a look at how various universal programmes compare from different regions in a little more detail.

I certainly know I need to familiarise myself much more with the intracacies of the US health care system.

You'll have to tell me how it affects you personally - without giving away your bank account details of course!!!

Cheers:

MM


----------

