Why does the United States not have mandated paid maternity

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roronoa79
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06 May 2021, 7:30 pm

AngelRho wrote:
goldfish21 wrote:
AngelRho wrote:
goldfish21 wrote:
Sooo, you have nothing real to say in defence so you put words in my mouth and then attempt to insult my country after telling lies about yours? Interesting ways to make yourself feel better about being governed by people who don't care about you.

Ooooooooh, so YOU can put words in someone else's mouth and demean THEIR country, but it's an outrage when someone gives it back? Hmmmm...

I'm still wondering how indigenous Canadians are holding up.


Once again deflecting instead of admitting that Americans get shafted compared to ~everyone else in the developed world.. and then they defend the practices of those giving them the shaft! Possibly because they've been sold a lie that maybe, just maybe, if they go along with agreeing to deprive their fellow countrymen of the basics of modern life,

I wish I could be an indigenous Canadian. It must be sooooooo nice...

You undermine your argument with such a cop-out of a deflection. You think life is a picnic for native Americans here in the US? At least in Canada they have universal healthcare and don't have one of the two major political parties trying to make it harder for them to vote.

I'm guessing your story was meant to be inspiring, but I don't think I'm alone in finding it saddening more than anything else. No one deserves to live in fear of homelessness. Or poverty. Or unemployment. Do you honestly think you deserved those things? Hearing capitalists say they do think they deserve the misery that comes with the constant threat of poverty with no safety net sounds to me like hearing someone making excuses for someone who has abused or neglected them.

Treating stories like that as a vindication of our system and not a condemnation of it cannot possibly be helping your argument in the eyes of non-Americans. Non-Americans, does this sort of thing not just reinforce the idea that Americans are a people who have been collectively gaslit, abuse, and manipulated into accepting our own misery as desirable? Is it not sad? Is it not pitiable? Does it not sound narrow-sighted to consider one's personal success in rising above an unfair system as vindication of that system--something which requires ignoring the plight of those who could not overcome the odds against them--or worse, suggesting they and those dependent on them deserve their misery?

We must seem like a post-Puritanical nation which has internalized that we deserve whatever suffering we get. We must seem naive and misguided to think the world is fair like that.


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06 May 2021, 7:36 pm

@AngelRho I'll yield to your political understanding of the U.S. on this matter hehe.

roronoa79 wrote:
We're the wealthiest country on Earth--yet we are neither the largest nor most populous. Bigger, more populous countries than us have universal healthcare, and I don't hear them demanding the 'efficiency' of privatized medicine. I think we can manage it. If anything, the private healthcare system is much less efficient. So much money wasted on overhead and advertising.


There are two. China and India. China does not have fully public healthcare, but is working towards it. India does. They are both pretty shoddy for regular citizens that can't afford expensive private hospitals - no sane person would trade the private U.S. system, whatever its troubles for the state of healthcare in either of those countries.

I can speak more about the NHS - the UK's attempt at this. While it's better than China or India - it still isn't great. Despite what you may have heard from advocates - people can and do die due to poor healthcare provision, especially in poorer areas, often old people left rotting in beds in understaffed hospitals lacking the equipment they need and this was the case long before Brexit exacerbated the staffing problem. We often hear of people travelling to other countries for expensive treatments that the NHS simply can't fund. The trusts that run the NHS have to be brutal when it comes to choosing cost effective medicines. If you think insurance companies are bad when they prioritise money over life... It's been in perpetual crisis for decades, no matter how much money is thrown at it - it is a black hole of government spending. We cannot really afford it as is.

goldfish21 wrote:
So then do it like Canada. Socialized medicine is clear across the country, yes, but each Province & Territory administers it's own.


Not a good comparison. Canada's population is tiny compared to the U.S. It's significantly smaller than even the UK.

I tell you what is an interesting system though. Japan. Population about a 1/3 of the US. Not socialised, but heavily regulated, standardised, subsidised and price controlled. Hospitals run by doctors instead of bean counters and by law - not for profit. Insurance is mandatory, but there is state assistance for exceptional cases. Not free at the point of use - but very reasonable service fees. It solves so many of the problems of the NHS and the overall standard of care is very high, but because the NHS is a borderline religion here - we're stuck with this s**t.


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That the Dog returns to his Vomit and the Sow returns to her Mire,
And the burnt Fool’s bandaged finger goes wabbling back to the Fire;

And that after this is accomplished, and the brave new world begins
When all men are paid for existing and no man must pay for his sins,
As surely as Water will wet us, as surely as Fire will burn,
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goldfish21
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06 May 2021, 8:28 pm

Mikah wrote:
@AngelRho I'll yield to your political understanding of the U.S. on this matter hehe.

roronoa79 wrote:
We're the wealthiest country on Earth--yet we are neither the largest nor most populous. Bigger, more populous countries than us have universal healthcare, and I don't hear them demanding the 'efficiency' of privatized medicine. I think we can manage it. If anything, the private healthcare system is much less efficient. So much money wasted on overhead and advertising.


There are two. China and India. China does not have fully public healthcare, but is working towards it. India does. They are both pretty shoddy for regular citizens that can't afford expensive private hospitals - no sane person would trade the private U.S. system, whatever its troubles for the state of healthcare in either of those countries.

I can speak more about the NHS - the UK's attempt at this. While it's better than China or India - it still isn't great. Despite what you may have heard from advocates - people can and do die due to poor healthcare provision, especially in poorer areas, often old people left rotting in beds in understaffed hospitals lacking the equipment they need and this was the case long before Brexit exacerbated the staffing problem. We often hear of people travelling to other countries for expensive treatments that the NHS simply can't fund. The trusts that run the NHS have to be brutal when it comes to choosing cost effective medicines. If you think insurance companies are bad when they prioritise money over life... It's been in perpetual crisis for decades, no matter how much money is thrown at it - it is a black hole of government spending. We cannot really afford it as is.

goldfish21 wrote:
So then do it like Canada. Socialized medicine is clear across the country, yes, but each Province & Territory administers it's own.


Not a good comparison. Canada's population is tiny compared to the U.S. It's significantly smaller than even the UK.

I tell you what is an interesting system though. Japan. Population about a 1/3 of the US. Not socialised, but heavily regulated, standardised, subsidised and price controlled. Hospitals run by doctors instead of bean counters and by law - not for profit. Insurance is mandatory, but there is state assistance for exceptional cases. Not free at the point of use - but very reasonable service fees. It solves so many of the problems of the NHS and the overall standard of care is very high, but because the NHS is a borderline religion here - we're stuck with this s**t.


How is it not comparable?

If anything, Canada's systems should prove to America that universal systems can be deployed over incredibly vast geographic regions in a cost effective manner for such a "low," population of only ~38 Million people. And despite the huge size of our country AND low population, we're able to administer universal healthcare at a fraction of the cost per person as the American system costs them.

Just like with every other industry in the USA and volume/quantity discounts/economies of scale - USA should be able to do what we do, only better, for less money.

Instead, they do less, get less, and pay significantly more - because they're lining the pockets of layers of insurance companies and private hospitals and a smattering of publicly held corporations all in it for the earnings per share.

With 330 Million people and many more large densely populated cities, the USA should be able to have a far better single payer universal healthcare system than we could ever dream of here in Canada. But instead I read about Americans going bankrupt over simple medical expenses, or crowdfunding campaigns for surgeries no Canadian ever needs to even know the cost of.


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AngelRho
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06 May 2021, 8:42 pm

roronoa79 wrote:
AngelRho wrote:
goldfish21 wrote:
AngelRho wrote:
goldfish21 wrote:
Sooo, you have nothing real to say in defence so you put words in my mouth and then attempt to insult my country after telling lies about yours? Interesting ways to make yourself feel better about being governed by people who don't care about you.

Ooooooooh, so YOU can put words in someone else's mouth and demean THEIR country, but it's an outrage when someone gives it back? Hmmmm...

I'm still wondering how indigenous Canadians are holding up.


Once again deflecting instead of admitting that Americans get shafted compared to ~everyone else in the developed world.. and then they defend the practices of those giving them the shaft! Possibly because they've been sold a lie that maybe, just maybe, if they go along with agreeing to deprive their fellow countrymen of the basics of modern life,

I wish I could be an indigenous Canadian. It must be sooooooo nice...

You undermine your argument with such a cop-out of a deflection. You think life is a picnic for native Americans here in the US?

Check your privilege. Besides, it's relevant. You can't pick on the US about "depriving...of the basics of modern life" when your country does exactly that and not expect someone to hit back. goldfish21 knows good and well that I'm right.



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06 May 2021, 8:45 pm

AngelRho wrote:
roronoa79 wrote:
AngelRho wrote:
goldfish21 wrote:
AngelRho wrote:
goldfish21 wrote:
Sooo, you have nothing real to say in defence so you put words in my mouth and then attempt to insult my country after telling lies about yours? Interesting ways to make yourself feel better about being governed by people who don't care about you.

Ooooooooh, so YOU can put words in someone else's mouth and demean THEIR country, but it's an outrage when someone gives it back? Hmmmm...

I'm still wondering how indigenous Canadians are holding up.


Once again deflecting instead of admitting that Americans get shafted compared to ~everyone else in the developed world.. and then they defend the practices of those giving them the shaft! Possibly because they've been sold a lie that maybe, just maybe, if they go along with agreeing to deprive their fellow countrymen of the basics of modern life,

I wish I could be an indigenous Canadian. It must be sooooooo nice...

You undermine your argument with such a cop-out of a deflection. You think life is a picnic for native Americans here in the US?

Check your privilege. Besides, it's relevant. You can't pick on the US about "depriving...of the basics of modern life" when your country does exactly that and not expect someone to hit back. goldfish21 knows good and well that I'm right.


Canada's historic (and present) mistreatment of Indigenous people, which the USA has approximately the exact same track record of, is somehow a relevant justification to American citizens not deserving the same basic public services as the rest of the developed world? :? Make it make sense.


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AngelRho
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06 May 2021, 9:32 pm

goldfish21 wrote:
Mikah wrote:
@AngelRho I'll yield to your political understanding of the U.S. on this matter hehe.

roronoa79 wrote:
We're the wealthiest country on Earth--yet we are neither the largest nor most populous. Bigger, more populous countries than us have universal healthcare, and I don't hear them demanding the 'efficiency' of privatized medicine. I think we can manage it. If anything, the private healthcare system is much less efficient. So much money wasted on overhead and advertising.


There are two. China and India. China does not have fully public healthcare, but is working towards it. India does. They are both pretty shoddy for regular citizens that can't afford expensive private hospitals - no sane person would trade the private U.S. system, whatever its troubles for the state of healthcare in either of those countries.

I can speak more about the NHS - the UK's attempt at this. While it's better than China or India - it still isn't great. Despite what you may have heard from advocates - people can and do die due to poor healthcare provision, especially in poorer areas, often old people left rotting in beds in understaffed hospitals lacking the equipment they need and this was the case long before Brexit exacerbated the staffing problem. We often hear of people travelling to other countries for expensive treatments that the NHS simply can't fund. The trusts that run the NHS have to be brutal when it comes to choosing cost effective medicines. If you think insurance companies are bad when they prioritise money over life... It's been in perpetual crisis for decades, no matter how much money is thrown at it - it is a black hole of government spending. We cannot really afford it as is.

goldfish21 wrote:
So then do it like Canada. Socialized medicine is clear across the country, yes, but each Province & Territory administers it's own.


Not a good comparison. Canada's population is tiny compared to the U.S. It's significantly smaller than even the UK.

I tell you what is an interesting system though. Japan. Population about a 1/3 of the US. Not socialised, but heavily regulated, standardised, subsidised and price controlled. Hospitals run by doctors instead of bean counters and by law - not for profit. Insurance is mandatory, but there is state assistance for exceptional cases. Not free at the point of use - but very reasonable service fees. It solves so many of the problems of the NHS and the overall standard of care is very high, but because the NHS is a borderline religion here - we're stuck with this s**t.


How is it not comparable?

If anything, Canada's systems should prove to America that universal systems can be deployed over incredibly vast geographic regions in a cost effective manner for such a "low," population of only ~38 Million people. And despite the huge size of our country AND low population, we're able to administer universal healthcare at a fraction of the cost per person as the American system costs them.

Just like with every other industry in the USA and volume/quantity discounts/economies of scale - USA should be able to do what we do, only better, for less money.

Instead, they do less, get less, and pay significantly more - because they're lining the pockets of layers of insurance companies and private hospitals and a smattering of publicly held corporations all in it for the earnings per share.

With 330 Million people and many more large densely populated cities, the USA should be able to have a far better single payer universal healthcare system than we could ever dream of here in Canada. But instead I read about Americans going bankrupt over simple medical expenses, or crowdfunding campaigns for surgeries no Canadian ever needs to even know the cost of.

That's right. Kinda like the way Jordan River Anderson's family never needed to know the cost of his care? Or how easily Jeremy Meawasiage had all his medical needs met? Let's talk about how ALL Canadians have access to care. Or...oh wait...is universal health care in Canada just for white people?



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06 May 2021, 9:47 pm

goldfish21 wrote:
AngelRho wrote:
roronoa79 wrote:
AngelRho wrote:
goldfish21 wrote:
AngelRho wrote:
goldfish21 wrote:
Sooo, you have nothing real to say in defence so you put words in my mouth and then attempt to insult my country after telling lies about yours? Interesting ways to make yourself feel better about being governed by people who don't care about you.

Ooooooooh, so YOU can put words in someone else's mouth and demean THEIR country, but it's an outrage when someone gives it back? Hmmmm...

I'm still wondering how indigenous Canadians are holding up.


Once again deflecting instead of admitting that Americans get shafted compared to ~everyone else in the developed world.. and then they defend the practices of those giving them the shaft! Possibly because they've been sold a lie that maybe, just maybe, if they go along with agreeing to deprive their fellow countrymen of the basics of modern life,

I wish I could be an indigenous Canadian. It must be sooooooo nice...

You undermine your argument with such a cop-out of a deflection. You think life is a picnic for native Americans here in the US?

Check your privilege. Besides, it's relevant. You can't pick on the US about "depriving...of the basics of modern life" when your country does exactly that and not expect someone to hit back. goldfish21 knows good and well that I'm right.


Canada's historic (and present) mistreatment of Indigenous people, which the USA has approximately the exact same track record of, is somehow a relevant justification to American citizens not deserving the same basic public services as the rest of the developed world? :? Make it make sense.

I'm not defending crap United States policies. I just don't believe adding more crap policies to existing ones is the answer. I also don't have any illusions that the existing system in my country is somehow superior. You're the one crowing about how amazing Canada is. While we're on that topic, how easily do young black people find getting access to mental health care in Canada? I bet it's SO NICE being a visible minority in Canada.



goldfish21
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06 May 2021, 11:54 pm

AngelRho wrote:
goldfish21 wrote:
AngelRho wrote:
roronoa79 wrote:
AngelRho wrote:
goldfish21 wrote:
AngelRho wrote:
goldfish21 wrote:
Sooo, you have nothing real to say in defence so you put words in my mouth and then attempt to insult my country after telling lies about yours? Interesting ways to make yourself feel better about being governed by people who don't care about you.

Ooooooooh, so YOU can put words in someone else's mouth and demean THEIR country, but it's an outrage when someone gives it back? Hmmmm...

I'm still wondering how indigenous Canadians are holding up.


Once again deflecting instead of admitting that Americans get shafted compared to ~everyone else in the developed world.. and then they defend the practices of those giving them the shaft! Possibly because they've been sold a lie that maybe, just maybe, if they go along with agreeing to deprive their fellow countrymen of the basics of modern life,

I wish I could be an indigenous Canadian. It must be sooooooo nice...

You undermine your argument with such a cop-out of a deflection. You think life is a picnic for native Americans here in the US?

Check your privilege. Besides, it's relevant. You can't pick on the US about "depriving...of the basics of modern life" when your country does exactly that and not expect someone to hit back. goldfish21 knows good and well that I'm right.


Canada's historic (and present) mistreatment of Indigenous people, which the USA has approximately the exact same track record of, is somehow a relevant justification to American citizens not deserving the same basic public services as the rest of the developed world? :? Make it make sense.

I'm not defending crap United States policies. I just don't believe adding more crap policies to existing ones is the answer. I also don't have any illusions that the existing system in my country is somehow superior. You're the one crowing about how amazing Canada is. While we're on that topic, how easily do young black people find getting access to mental health care in Canada? I bet it's SO NICE being a visible minority in Canada.


You ARE defending crap United States policies.

And then you're suggesting that countries looking after their citizens better have crap policies.. riiiight. :roll: :lol:

I'm not a young black person, so I can't speak from personal experience, but we don't ration healthcare based on race here.. so my best guess is that young black people would have about the same ease/difficulty as any other Canadian in accessing mental health care in Canada. I would Also imagine that they would deal with some racial biases in the medical system that glowing white folk don't, but that they wouldn't be As bad as they are stateside - simply because we have a much better blended society here.

But I dunno. I'm not black. My next door neighbours are - and some of very few here. BC has a high Asian and South Asian populations, as well as people from all over the world, but very few black people. People who have visited Vancouver from Toronto have asked "Where are all your black people?" because there are so few. Ummm, in Toronto I guess? Caribbean Days in Toronto is a massive festival - nothing like that here because we don't have the ethnic/cultural population to support it. Might get a better answer to your question by asking someone from Ontario.


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07 May 2021, 7:20 am

goldfish21 wrote:
Just like with every other industry in the USA and volume/quantity discounts/economies of scale - USA should be able to do what we do, only better, for less money.


That's not how governments work. Send out the government to buy a cake, they'll come back two days late with a piece of stale bread and no change. That is not to say everything should be privatised, the piece of stale bread is often preferable to whatever dystopia the private sector can cook up. But the inefficiencies, the bureaucracy, the short term thinking, the political point scoring are real and they scale exponentially with the population. Again I think Japan would be a better model for the US to try.


_________________
As it will be in the future, it was at the birth of Man -
There are only four things certain since Social Progress began: -
That the Dog returns to his Vomit and the Sow returns to her Mire,
And the burnt Fool’s bandaged finger goes wabbling back to the Fire;

And that after this is accomplished, and the brave new world begins
When all men are paid for existing and no man must pay for his sins,
As surely as Water will wet us, as surely as Fire will burn,
The Gods of the Copybook Headings with terror and slaughter return!


goldfish21
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07 May 2021, 10:21 am

Mikah wrote:
goldfish21 wrote:
Just like with every other industry in the USA and volume/quantity discounts/economies of scale - USA should be able to do what we do, only better, for less money.


That's not how governments work. Send out the government to buy a cake, they'll come back two days late with a piece of stale bread and no change. That is not to say everything should be privatised, the piece of stale bread is often preferable to whatever dystopia the private sector can cook up. But the inefficiencies, the bureaucracy, the short term thinking, the political point scoring are real and they scale exponentially with the population. Again I think Japan would be a better model for the US to try.


Then fire them & elect someone else that will do the job that everyone knows can be done. If "lowly Canadians," can figure it out than surely with all the "American might and ingenuity," or whatever south of the border they can figure it out, too.. no?

https://www.salon.com/2020/02/15/americ ... n%20Canada.

Quote:
American health care system costs four times more than Canada's single-payer system
Average Americans pay $2,497 a year for insurance overhead and admin costs, while Canadians pay just $551
By IGOR DERYSH
FEBRUARY 15, 2020 3:00PM (UTC)

The cost of administering health care in the United States costs four times as much as it does in Canada, which has had a single-payer system for nearly 60 years, according to a new study.

The average American pays a whopping $2,497 per year in administrative costs — which fund insurer overhead and salaries of administrative workers as well as executive pay packages and growing profits — compared to $551 per person per year in Canada, according to a study published in the Annals of Internal Medicine last month. The study estimated that cutting administrative costs to Canadian levels could save more than $600 billion per year.

The data contradicts claims by opponents of single-payer health care systems, who have argued that private programs are more efficient than government-run health care. The debate over the feasibility of a single-payer health care has dominated the Democratic presidential race, where candidates like Sen. Bernie Sanders, I-Vt., and Sen. Elizabeth Warren, D-Mass., advocate for a system similar to Canada's while moderates like former Vice President Joe Biden and former South Bend, Indiana Mayor Pete Buttigieg have warned against scrapping private health care plans entirely.

Canada had administrative costs similar to those in the United States before it switched to a single-payer system in 1962, according to the study's authors, who are researchers at Harvard Medical School, the City University of New York at Hunter College, and the University of Ottawa. But by 1999, administrative costs accounted for 31% of American health care expenses, compared to less than 17% in Canada.

The costs have continued to increase since 1999. The study found that American insurers and care providers spent a total of $812 billion on administrative costs in 2017, more than 34% of all health care costs that year. The largest contributor to the massive price tag was insurance overhead costs, which totaled more than $275 billion in 2017.

"The U.S.-Canada disparity in administration is clearly large and growing," the study's authors wrote. "Discussions of health reform in the United States should consider whether $812 billion devoted annually to health administration is money well spent."

The increase in costs was driven in large part due to private insurers' growing role in administering publicly-funded Medicare and Medicaid programs. More than 50% of private insurers' revenue comes from Medicare and Medicaid recipients, according to the study. Roughly 12% of premiums for private Medicare Advantage plans are spent on overhead, compared to just 2% in traditional Medicare programs. Medicaid programs also showed a wide disparity in costs in states that shifted many of their Medicaid recipients into private managed care, where administrative costs are twice as high. There was little increase in states that have full control over their Medicaid programs.

As a result, Americans pay far more for the same care.

The average American spent $933 in hospital administration costs, compared to $196 in Canada, according to the research. Americans paid an average of $844 on insurance companies' overhead, compared to $146 in Canada. Americans spent an average of $465 for physicians' insurance-related costs, compared to $87 in Canada.

"The gap in health administrative spending between the United States and Canada is large and widening, and it apparently reflects the inefficiencies of the U.S. private insurance-based, multipayer system," the authors wrote. "The prices that U.S. medical providers charge incorporate a hidden surcharge to cover their costly administrative burden."

Despite the massive difference in administrative costs, a 2007 study by the Centers for Disease Control and Canada's health authority found that the overall health of residents in both countries is very similar, though the US actually trails in life expectancy, infant mortality, and fitness.

Many of the additional administrative costs in the US go toward compensation packages for insurance executives, some of whom pocket more than $20 million per year, and billions in profits collected by insurers.

"Americans spend twice as much per person as Canadians on health care. But instead of buying better care, that extra spending buys us sky-high profits and useless paperwork," said Dr. David Himmelstein, the study's lead author and a distinguished professor at Hunter College. "Before their single-payer reform, Canadians died younger than Americans, and their infant mortality rate was higher than ours. Now Canadians live three years longer and their infant mortality rate is 22% lower than ours. Under Medicare for All, Americans could cut out the red tape and afford a Rolls Royce version of Canada's system."

Himmelstein later told Time that the difference in administrative costs between the two countries would "not only cover all the uninsured but also eliminate all the copayments and deductibles."

"And, frankly, have money left over," he added.

Democrats like Biden and Buttigieg have argued that it would be a mistake to switch to a single-payer system because many people have private insurance plans they like. Both have proposed a public option, which would allow people to buy into a government-run health care program but would not do away with private plans.

But study senior author Dr. Steffie Woolhandler, at Hunter College and lecturer at Harvard Medical School, argued that a public option would make things worse, not better, because they would leave profit-seeking private insurance in place.

"Medicare for All could save more than $600 billion each year on bureaucracy, and repurpose that money to cover America's 30 million uninsured and eliminate copayments and deductibles for everyone," she said. "Reforms like a public option that leave private insurers in place can't deliver big administrative savings. As a result, public option reform would cost much more and cover much less than Medicare for All."


IGOR DERYSH
Igor Derysh is a staff writer at Salon. His work has also appeared in the Los Angeles Times, Chicago Tribune, Boston Herald and Baltimore Sun.

Tips/Email: iderysh@salon.com Twitter: @IgorDerysh

MORE FROM IGOR DERYSH


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07 May 2021, 10:28 am

TITLE BOUT

Canada vs. England

Topic: "What America Should Do"

Prize: Bragging Rights


(Marquess of Queensbury Rules)


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07 May 2021, 10:47 am

:lol:


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07 May 2021, 11:11 am

goldfish21 wrote:
Mikah wrote:
goldfish21 wrote:
Just like with every other industry in the USA and volume/quantity discounts/economies of scale - USA should be able to do what we do, only better, for less money.


That's not how governments work. Send out the government to buy a cake, they'll come back two days late with a piece of stale bread and no change. That is not to say everything should be privatised, the piece of stale bread is often preferable to whatever dystopia the private sector can cook up. But the inefficiencies, the bureaucracy, the short term thinking, the political point scoring are real and they scale exponentially with the population. Again I think Japan would be a better model for the US to try.


Then fire them & elect someone else that will do the job that everyone knows can be done. If "lowly Canadians," can figure it out than surely with all the "American might and ingenuity," or whatever south of the border they can figure it out, too.. no?

https://www.salon.com/2020/02/15/americ ... n%20Canada.

Quote:
American health care system costs four times more than Canada's single-payer system
Average Americans pay $2,497 a year for insurance overhead and admin costs, while Canadians pay just $551
By IGOR DERYSH
FEBRUARY 15, 2020 3:00PM (UTC)

The cost of administering health care in the United States costs four times as much as it does in Canada, which has had a single-payer system for nearly 60 years, according to a new study.

The average American pays a whopping $2,497 per year in administrative costs — which fund insurer overhead and salaries of administrative workers as well as executive pay packages and growing profits — compared to $551 per person per year in Canada, according to a study published in the Annals of Internal Medicine last month. The study estimated that cutting administrative costs to Canadian levels could save more than $600 billion per year.

The data contradicts claims by opponents of single-payer health care systems, who have argued that private programs are more efficient than government-run health care. The debate over the feasibility of a single-payer health care has dominated the Democratic presidential race, where candidates like Sen. Bernie Sanders, I-Vt., and Sen. Elizabeth Warren, D-Mass., advocate for a system similar to Canada's while moderates like former Vice President Joe Biden and former South Bend, Indiana Mayor Pete Buttigieg have warned against scrapping private health care plans entirely.

Canada had administrative costs similar to those in the United States before it switched to a single-payer system in 1962, according to the study's authors, who are researchers at Harvard Medical School, the City University of New York at Hunter College, and the University of Ottawa. But by 1999, administrative costs accounted for 31% of American health care expenses, compared to less than 17% in Canada.

The costs have continued to increase since 1999. The study found that American insurers and care providers spent a total of $812 billion on administrative costs in 2017, more than 34% of all health care costs that year. The largest contributor to the massive price tag was insurance overhead costs, which totaled more than $275 billion in 2017.

"The U.S.-Canada disparity in administration is clearly large and growing," the study's authors wrote. "Discussions of health reform in the United States should consider whether $812 billion devoted annually to health administration is money well spent."

The increase in costs was driven in large part due to private insurers' growing role in administering publicly-funded Medicare and Medicaid programs. More than 50% of private insurers' revenue comes from Medicare and Medicaid recipients, according to the study. Roughly 12% of premiums for private Medicare Advantage plans are spent on overhead, compared to just 2% in traditional Medicare programs. Medicaid programs also showed a wide disparity in costs in states that shifted many of their Medicaid recipients into private managed care, where administrative costs are twice as high. There was little increase in states that have full control over their Medicaid programs.

As a result, Americans pay far more for the same care.

The average American spent $933 in hospital administration costs, compared to $196 in Canada, according to the research. Americans paid an average of $844 on insurance companies' overhead, compared to $146 in Canada. Americans spent an average of $465 for physicians' insurance-related costs, compared to $87 in Canada.

"The gap in health administrative spending between the United States and Canada is large and widening, and it apparently reflects the inefficiencies of the U.S. private insurance-based, multipayer system," the authors wrote. "The prices that U.S. medical providers charge incorporate a hidden surcharge to cover their costly administrative burden."

Despite the massive difference in administrative costs, a 2007 study by the Centers for Disease Control and Canada's health authority found that the overall health of residents in both countries is very similar, though the US actually trails in life expectancy, infant mortality, and fitness.

Many of the additional administrative costs in the US go toward compensation packages for insurance executives, some of whom pocket more than $20 million per year, and billions in profits collected by insurers.

"Americans spend twice as much per person as Canadians on health care. But instead of buying better care, that extra spending buys us sky-high profits and useless paperwork," said Dr. David Himmelstein, the study's lead author and a distinguished professor at Hunter College. "Before their single-payer reform, Canadians died younger than Americans, and their infant mortality rate was higher than ours. Now Canadians live three years longer and their infant mortality rate is 22% lower than ours. Under Medicare for All, Americans could cut out the red tape and afford a Rolls Royce version of Canada's system."

Himmelstein later told Time that the difference in administrative costs between the two countries would "not only cover all the uninsured but also eliminate all the copayments and deductibles."

"And, frankly, have money left over," he added.

Democrats like Biden and Buttigieg have argued that it would be a mistake to switch to a single-payer system because many people have private insurance plans they like. Both have proposed a public option, which would allow people to buy into a government-run health care program but would not do away with private plans.

But study senior author Dr. Steffie Woolhandler, at Hunter College and lecturer at Harvard Medical School, argued that a public option would make things worse, not better, because they would leave profit-seeking private insurance in place.

"Medicare for All could save more than $600 billion each year on bureaucracy, and repurpose that money to cover America's 30 million uninsured and eliminate copayments and deductibles for everyone," she said. "Reforms like a public option that leave private insurers in place can't deliver big administrative savings. As a result, public option reform would cost much more and cover much less than Medicare for All."


IGOR DERYSH
Igor Derysh is a staff writer at Salon. His work has also appeared in the Los Angeles Times, Chicago Tribune, Boston Herald and Baltimore Sun.

Tips/Email: iderysh@salon.com Twitter: @IgorDerysh

MORE FROM IGOR DERYSH

The article you posted is not entirely wrong, and it seems to affirm what Mikah is saying. It's worth me repeating that you don't understand the culture, politics, and bureaucracy of the United States.

You said "fire them and elect someone else." That's just it. Regional party leaders don't want to run candidates that can't win. Let's say for the sake of argument Nancy Pelosi's constituents can't stand her and would rather vote her out of office. The pattern has typically been that any time you vote out your incumbent in the primaries, the opposition party ends up winning the election. So even if they hated Pelosi, first of all nobody wants to run against her; and second, they'd rather keep her even if they hate her because it means they can hold power in Congress as either speaker of the house or minority leader. It's slightly more likely a Republican would win her seat and that Democrats would be stuck for the next several election cycles. Even if they knew it was likely a Republican wouldn't last more than two short terms, they're not interested in taking that risk. Because Pelosi is a VIP in the Democrat party and holds a lot of congressional power even if they lose the majority, nobody wants to be "that guy" who screws up San Francisco's special place in national policymaking. She can't keep her seat forever, though, and it's going to be mass chaos when she retires or dies.

Where I'm from, I hear conversations about that kind of thing all the time. I keep hearing people say, "well why can't California or New York or Minnesota just elect someone else?" Yeah, I mean, that's just it. People from California, New York, and Minnesota say the exact same thing about Mississippi, Alabama, Texas, and Florida. We don't let them interfere with our electoral decisions, and we don't have the right to tell them how to vote, either. Our problem, goldfish21, is we have too many candidates scared to run for office and too many voters who lack the courage to demand better.

Regarding the not-so-universal-health-care in Canada:

Members of Black communities across Canada are overrepresented in a number of other medical conditions, including cancer, kidney disease, hypertension, HIV and AIDS, diabetes, psychosis and mental illness. As Dr. Christopher Morgan, founder of the Black Health Alliance, puts it: “Broadly speaking, if we had to give a grade to the health and wellbeing of the Black community, it’s a failing grade.” In issues of mental health in particular, Morgan says many Black Canadians struggle to access available services until mental conditions have significantly progressed. “Whereas people outside of the Black community with similar conditions have typical access points to mental health services within 3-6 months. In the case of Black folk, it’s often 16-18 months and it’s often through police incarceration.”



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07 May 2021, 3:22 pm

Excuses excuses.. sounds an awful lot like "..but he only beats me on days that end in Y."

Like I said, I can't speak for or about the black community in Canada - because I'm not black And we don't Have a significant black community here. I do wonder what the causes of what you posted, are, though. Cultural hesitation and sitgma preventing people from seeking mental health services? Or bias of healthcare professionals not allowing access to care? Some other factor or combination? I have no idea - for the reasons stated.. I'm not black and there are very few black people around me.


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08 May 2021, 7:13 am

goldfish21 wrote:
Excuses excuses.. sounds an awful lot like "..but he only beats me on days that end in Y."

Like I said, I can't speak for or about the black community in Canada - because I'm not black And we don't Have a significant black community here. I do wonder what the causes of what you posted, are, though. Cultural hesitation and sitgma preventing people from seeking mental health services? Or bias of healthcare professionals not allowing access to care? Some other factor or combination? I have no idea - for the reasons stated.. I'm not black and there are very few black people around me.

Then you get what I’m saying. You have a racist health care system. But because your government doesn’t collect data and because you keep “visible minorities” and First Nations out of sight and out of mind, you can look the other way and pretend everything is just hunky-dory. Hopefully you can see that Canada does NOT have universal healthcare, only universal healthcare for WHITE people.

The United States has a more diverse population with minorities concentrating in big cities and the south. I remember laughing when I heard there was a BLM parade in Potsdam, NY (I’m a SUNY graduate). I’m curious how many local families are black. Not many. And it’s insulting when students turn out and it’s a case of mass virtue signaling and white guilt. THESE are the people who think they know so much about what everyone else in America should be doing or how we should be voting when they wouldn’t be caught dead in an inner city neighborhood or anywhere in the Mississippi Delta. If Canada doesn’t even have universal healthcare (contrary to their claims) or any history of experience with minority and civil rights concerns, the United States most certainly has no use for Canada’s advice.

Besides that...the US and Canada aren’t even remotely the same country or culture. Canada clearly has an indigenous problem, but it’s a CANADA problem, not a US problem. The only times Native Americans kick up now is when there’s some imminent domain question concerning tribal lands, and you can’t blame them for that. Otherwise, you have a few isolated situations of cultural appropriation or someone getting offended by a football team’s name. I want to start a pro football team and call them “The Savages.” I bet something like that would go over well in Montreal, don’t you think? Change the Canadiens to the Savages, have them play the Leafs tonight at 6 pm. The Savages vs. the Leafs. Nice ring to it, eh? If that’s the worst you have to worry about in the US, do you think Canada could stand some good American advice on the treatment of First Nations?



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08 May 2021, 5:16 pm

American health care is for rich people.

Americans mostly like their health care, because they're so rich.

Americans can get specialized medical care immediately. <--- Rich

While in Canada, they have long wait lists <--Poorer

America have highly paid medical staff with the latest medical devices, latest drug development <--Rich

While in Canada, you're likely on a tight budget, government controlled spending, waiting on Americans to develop devices, and drugs for you. <---Poorer

Americans get access to the best doctors in the world because they can earn the most. America "brain drains" the world of doctors. <--- Rich

While in Canada, government controlled pay likely leads to less talented doctors <---Poorer


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